How to Access TRICARE Providers and Facilities (2026 Guide)

*Disclaimer: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy and the most current data, visit TRICARE.mil.*

## Quick answer To access TRICARE providers and facilities, you must first determine if you are using the **Direct Care** system (military hospitals/clinics) or the **Purchased Care** network (civilian doctors). Your ability to see a specific provider depends on your plan—TRICARE Prime usually requires a referral and assigned Primary Care Manager (PCM), while TRICARE Select allows you to visit any TRICARE-authorized provider without a referral.

In detail

Accessing care under the TRICARE system is divided into two distinct pathways: Military Treatment Facilities (MTFs) and the civilian provider network managed by regional contractors (**Humana Military** in the East and **TriWest Healthcare Alliance** in the West).

### 1. Finding a Provider Depending on your location and plan, you will search for providers through different portals: * **Military Hospitals and Clinics:** Use the [MTF Locator](https://tricare.mil/mtf) to find direct care facilities on or near military installations. * **Civilian Network (East):** Managed by Humana Military. Use their online provider directory to find "Network" or "Participating" providers. * **Civilian Network (West):** Managed by TriWest Healthcare Alliance (as of early 2025). Their directory includes civilian doctors who have agreed to TRICARE's payment rates and administrative requirements.

### 2. Provider Types and Costs Your out-of-pocket costs (2026 rates) depend heavily on the *status* of the provider you choose:

| Provider Type | Access Requirements | Out-of-Pocket Costs | | :--- | :--- | :--- | | **Military (MTF)** | Priority given to Prime enrollees. | Usually $0 for active duty/dependents. | | **Network Provider** | Contracted with Humana or TriWest. | Fixed copayments (e.g., ~$38–$40 for Select Group A retirees in 2026). | | **Non-Network (Participating)** | Accept TRICARE but no long-term contract. | Higher cost-shares; provider accepts TRICARE's "allowable charge." | | **Non-Network (Non-Participating)** | Do not accept TRICARE rates. | Highest costs; can charge up to 15% above the TRICARE allowable amount. |

### 3. Referrals and Authorizations * **TRICARE Prime:** You are assigned a Primary Care Manager (PCM). To see a specialist, your PCM must submit a referral to your regional contractor. If you see a specialist without this, you will be charged under the **Point of Service (POS) option**, which includes a $300 deductible and 50% cost-shares. * **TRICARE Select:** No referrals are required for most specialty care. You can self-refer to any TRICARE-authorized provider. * **Prescriptions:** Access is managed through **Express Scripts**. You can use MTF pharmacies ($0 cost), Home Delivery, or retail network pharmacies (CVS, Walgreens, etc.).

### 4. Overseas Access For beneficiaries living outside the U.S., provider access is coordinated by **International SOS**. In many overseas locations, TRICARE Prime Overseas members must use the MTF, while those in remote areas use the TRICARE Overseas Program (TOP) network.

## Who this applies to * **Active Duty Service Members (ADSMs):** Must use MTFs first and require referrals for all civilian care; $0 out-of-pocket. * **Active Duty Family Members (ADFMs):** Can choose Prime (managed care) or Select (freedom of choice). * **Retirees and Families:** Access depends on enrollment in Prime or Select; subject to annual deductibles and enrollment fees (2026 rates vary by Group A or B). * **Guard/Reserve:** Access providers via TRICARE Reserve Select (TRS), which functions similarly to the Select plan.

Common scenarios

**Scenario 1: The Prime Specialist Visit** Jane is an ADFM on TRICARE Prime in the West Region. She needs to see a dermatologist. She visits her PCM at the local MTF, who submits an electronic referral to **TriWest**. Once approved, Jane sees a network dermatologist and pays a **$0 copay** (as ADFMs on Prime typically have no copays for covered office visits in 2026).

**Scenario 2: The Select Self-Referral** Mark is a retired veteran (Group A) on TRICARE Select in the East Region. He wants to see an orthopedic surgeon for knee pain. He does not need a referral. He finds a network surgeon through **Humana Military**. In 2026, he pays his annual deductible first, then a fixed copay (approximately **$38–$45 depending on the specific service**) for the specialist office visit.

**Scenario 3: Using a Non-Participating Provider** Sarah is on TRICARE Select and sees a therapist who is "TRICARE-authorized" but "non-participating." The therapist charges $150, but the TRICARE allowable charge is $100. Sarah is responsible for her standard cost-share PLUS the extra 15% ($15) that the provider is allowed to "balance bill."

## Related terms * **PCM (Primary Care Manager):** The doctor responsible for your overall care and referrals in a Prime plan. * **Authorized Provider:** A doctor or facility that meets TRICARE's licensing and certification requirements. * **Allowable Charge:** The maximum amount TRICARE will pay for a covered medical service. * **Point of Service (POS):** An option for Prime members to see non-network providers without a referral, resulting in significantly higher costs. * **Network Provider:** A civilian provider who has a contract with the regional manager (Humana or TriWest) to provide care at a negotiated rate.

## Sources * TRICARE.mil: [Find a Doctor](https://tricare.mil/findaprovider) * Humana Military (East Region): [Provider Search](https://www.humanamilitary.com/beneficiary/find-care) * TriWest Healthcare Alliance (West Region): [Provider Directory](https://www.triwest.com/) * Express Scripts: [Pharmacy Locator](https://www.express-scripts.com/tricare)