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What is the difference between network and non-network providers?
Verified by TRICARE.com Editorial Team
Updated 2024-12-01
AI-assisted (gemini)
Quick Answer
Network providers accept TRICARE rates and file claims for you. Non-network providers may charge more, and you may need to file claims yourself.
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Key Takeaways
- Network providers accept TRICARE rates
- Non-network may cost more
- Network files claims for you
- Check provider status before visit
Detailed Answer
Understanding network status affects your costs and convenience.
Network Providers
- Contracted with TRICARE
- Accept TRICARE-allowed amounts
- File claims for you
- Cannot bill you extra (balance billing)
- Lower cost shares
Non-Network Providers
- Not contracted with TRICARE
- May charge above TRICARE rates
- You may file claims
- Can balance bill (some protections)
- Higher cost shares
Finding Network Providers
- Use TRICARE provider directory online
- Call regional contractor
- Ask provider before appointment
Cost Differences
- Network: 15-20% cost share typical
- Non-network: 20-25% cost share typical
- Non-network may have balance billing
- Higher deductibles may apply
Balance Billing
- Network cannot balance bill
- Some non-network protections exist
- Emergency care protected
- Always ask about costs upfront
Related TRICARE Terms
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