What is a network provider in TRICARE?

A network provider in TRICARE is a healthcare provider (physician, hospital, clinic, or other medical professional) that has entered into a contract with one of TRICARE's regional contractors (Humana Military for the East Region or TriWest Healthcare Alliance for the West Region) to provide services to TRICARE beneficiaries at negotiated rates. Using network providers offers several advantages: they accept the TRICARE-allowable charge as full payment, they file claims on the beneficiary's behalf, they result in lower out-of-pocket costs compared to non-network providers, and they have agreed to meet TRICARE quality standards. Under TRICARE Select, using network providers results in lower copays and cost-shares than using non-network providers. Under TRICARE Prime, most care should be received through network providers or the military treatment facility. Beneficiaries can search for network providers through their regional contractor's online provider directory or by calling their contractor's customer service line. Verifying network status before each visit is recommended as provider participation can change.