TRICARE.com

TRICARE Coverage for Allusion Clinics and Services

Guide to understanding TRICARE coverage for Allusion-branded medical clinics and diagnostic services, including 2026 cost-shares and regional contractor info.

TRICARE Coverage for Allusion Clinics and Services

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy, visit TRICARE.mil.*

## Quick answer "Allusion" is not a TRICARE benefit or insurance term; rather, it refers to a specific type of medical imaging software (often Aluvone or similar diagnostic platforms) or, more commonly in a military medical context, the name of several civilian medical clinics and mental health groups. If you are seeking care at an "Allusion" branded facility, coverage depends on whether that specific clinic is in-network with TriWest (West Region) or Humana Military (East Region).

## In detail While "Allusion" is not an official TRICARE program, many beneficiaries encounter this name through private healthcare providers or specialized diagnostic software used by military treatment facilities (MTFs).

### Network Status and Managed Care If you are visiting a provider with "Allusion" in the name—such as Allusion Health or Allusion Mental Health—your out-of-pocket costs are determined by your TRICARE plan and the provider's contract status.

* **TRICARE Prime:** You generally need a referral to see a civilian specialist. If you go to an Allusion clinic without a referral, you will be charged under the **Point of Service (POS) option**, which includes a $300 deductible for individuals (2026 rates). * **TRICARE Select:** You do not need a referral. However, you will pay lower cost-shares if the clinic is an "In-Network" provider.

### Regional Contractors (As of 2026) As of the T-5 contract transition that began in 2025, ensure you are checking the correct portal to verify if a provider is in-network: * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance** (previously Health Net).

### Diagnostic Technology Some beneficiaries may see "Allusion" referenced in medical records regarding 3D imaging or vascular mapping. TRICARE typically covers diagnostic imaging (Ultrasounds, MRIs, CT scans) when they are: 1. Medically necessary. 2. Proven (not experimental). 3. Ordered by a TRICARE-authorized provider.

### 2026 Cost-Share Estimates (Group A) | Service Type | TRICARE Prime (In-Network) | TRICARE Select (In-Network) | | :--- | :--- | :--- | | Specialty Office Visit | $0 (with referral) | ~$35 - $50 (varies by year) | | Diagnostic Radiology | $0 | 20% of allowed charge | | Point of Service (POS) | 50% of allowed charge | N/A |

## Who this applies to * **Active Duty Service Members (ADSMs):** Must have a referral and typically must seek care at an MTF first. Civilian care at Allusion clinics is only covered with a NAS (Non-Availability Statement) or prior authorization. * **Active Duty Family Members (ADFMs):** Can use Allusion clinics via TRICARE Select without a referral or via Prime with a referral. * **Retirees:** Subject to annual deductibles and enrollment fees (2026 rates vary by Group A or B). * **TRICARE Reserve Select (TRS) Users:** Can visit any authorized provider, but in-network status significantly reduces out-of-pocket costs.

Common scenarios

**Scenario 1: Mental Health Referral (Prime)** Sgt. Miller (Active Duty) is referred by her PCM to "Allusion Counseling" in the West Region. Because she has a 2026 authorization from TriWest, her out-of-pocket cost is **$0**.

**Scenario 2: Diagnostic Imaging (Select)** A retiree on TRICARE Select visits an imaging center using Allusion software for a medically necessary scan. The center is in-network. The retiree pays a **20% cost-share** of the TRICARE-allowable rate after meeting their 2026 deductible.

**Scenario 3: Self-Referral (Prime POS)** An ADFM on TRICARE Prime visits an Allusion-branded clinic for a specialty consultation without a PCM referral. They are charged under the Point of Service option, paying a **$300 deductible** plus 50% of the covered charge for the visit.

## Related terms * **Network Provider:** A healthcare provider that has a contract with Humana Military or TriWest to provide care at negotiated rates. * **Point of Service (POS) Option:** An expensive cost-sharing track for Prime members who seek non-emergency care without a referral. * **TriWest Healthcare Alliance:** The current (2026) contractor for the TRICARE West Region. * **Humana Military:** The current contractor for the TRICARE East Region. * **Medically Necessary:** Care that is appropriate, reasonable, and adequate for your condition according to TRICARE standards.

## Sources * TRICARE Official Site: [TRICARE.mil](https://www.tricare.mil) * Humana Military (East): [HumanaMilitary.com](https://www.humanamilitary.com) * TriWest Healthcare Alliance (West): [TriWest.com](https://www.triwest.com) * TRICARE Cost Search Tool: [TRICARE.mil/costs](https://www.tricare.mil/costs)