TRICARE-authorized Providers |
TRICARE-authorized providers meet state licensing and certification requirements and are certified by TRICARE to provide care to TRICARE beneficiaries. TRICARE-authorized providers include doctors, hospitals, ancillary providers (laboratories and radiology providers) and pharmacies. Beneficiaries are responsible for the full cost of care if they see providers who are not TRICARE-authorized. There are two types of TRICARE-authorized providers: Network and Non-network.
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Network Providers1 |
Non-Network Providers2 |
- Regional contractors have established networks, even in areas far from military treatment facilities
- TRICARE network providers:
- Have signed agreements with Humana Military Healthcare Services, Inc. (Humana Military) to provide care
- Agree to file claims and handle other paperwork for TRICARE beneficiaries
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- Non-network providers do not have signed agreements with Humana Military and are, therefore, considered “out of network.”
- There are two types of non-network providers: Participating and Nonparticipating.
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Participating |
Nonparticipating |
- May choose to participate on a claim-by-claim basis
- Agree to file claims for TRICARE beneficiaries, accept payment directly from TRICARE, and accept the TRICARE-allowable charge as payment in full for their services
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- Do not agree to accept the TRICARE-allowable charge or file claims for TRICARE beneficiaries.
- Have the legal right to charge beneficiaries up to 15 percent above the TRICARE-allowable charge for services.
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