TRICARE Network Guide: How to Find Providers & Save Money

*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 current provider directory, visit [TRICARE.mil](https://www.tricare.mil).*

## Quick answer The TRICARE network is a massive group of civilian doctors, hospitals, and pharmacies that have signed legal agreements with TRICARE’s regional contractors to provide care at discounted, pre-negotiated rates. Using "Network Providers" generally results in lower out-of-pocket costs and no paperwork for the beneficiary, as these providers agree to file claims directly with TRICARE.

## In detail The TRICARE network is managed by two primary regional contractors. As of 2026, **Humana Military** manages the East Region, and **TriWest Healthcare Alliance** manages the West Region.

### Types of Network Providers * **Individual Providers:** Doctors, specialists, nurses, and therapists. * **Facilities:** Hospitals, urgent care centers, and ambulatory surgery centers. * **Pharmacies:** Retail pharmacies (managed by Express Scripts) that participate in the TRICARE network.

### Network vs. Non-Network Providers The distinction between these categories determines your financial liability:

### Regional Management (T-5 Contract) Effective January 1, 2025, the T-5 contract changed the landscape of the TRICARE network: * **East Region:** Remains under Humana Military. Covers approximately 30 states. * **West Region:** Now managed by TriWest Healthcare Alliance. * **The Directory:** Each contractor maintains an online "Provider Directory." This is the only definitive way to confirm if a doctor is currently in-network.

### Referral and Authorization Rules The network functions differently depending on your plan: * **TRICARE Prime:** You are generally required to use the network. If you seek care outside the network without a referral (except for emergencies), you will be charged under the **Point of Service (POS) option**, which has a 2026 deductible (varies by year, check TRICARE.mil) and a 50% cost-share. * **TRICARE Select:** You have the freedom to see any TRICARE-authorized provider, but your copays are significantly lower if you choose a network provider.

## Who this applies to * **Active Duty Service Members (ADSMs):** Must use Military Hospitals and Clinics or network providers via referral; they almost never use non-network care. * **Active Duty Family Members (ADFMs):** Have the most flexibility. On Prime, stay in-network to avoid POS fees; on Select, stay in-network to keep copays low (e.g., ~$30-$40 for a specialist visit in 2026 vs. 20% of the allowed amount). * **Retirees and their Families:** Network status is critical for Group A and Group B retirees to manage their annual catastrophic caps. * **TRICARE Reserve Select (TRS) / Retired Reserve (TRRR) Users:** Beneficiaries pay lower cost-shares when staying within the TriWest or Humana network.

Common scenarios

**Scenario 1: Using the West Region Network** Jane is a TRICARE Select beneficiary in Arizona (West Region). She sees a specialist for a knee injury. * **Network Provider:** She pays a fixed 2026 copay of $38. The provider handles all paperwork with TriWest. * **Non-Network Provider:** Jane might pay a 20% cost-share of the TRICARE allowed amount, plus the provider could charge up to 15% above the allowed amount ("balance billing").

**Scenario 2: The Point of Service Trap** Mark is on TRICARE Prime in the East Region. He goes to a network dermatologist without a referral from his Primary Care Manager (PCM). Because it is a "self-referral" for specialty care, Humana Military processes the claim under the Point of Service option. Mark must pay a $300 deductible (2026 rate for individuals) and 50% of the bill thereafter.

**Scenario 3: Retail Pharmacy Network** Sarah needs an antibiotic. She goes to a network pharmacy (like Walgreens or a grocery store chain). She pays the 2026 network copay (~$16 for brand name). If she went to a non-network pharmacy, she would have to pay the full price upfront and file a claim for partial reimbursement.

## Related terms * **Authorized Provider:** A provider who meets TRICARE's licensing and certification standards but might not have a signed contract (can be network or non-network). * **Balance Billing:** When a non-participating provider charges you the difference between their bill and the TRICARE allowed amount (limited to 15%). * **TRICARE Allowed Amount:** The maximum dollar amount TRICARE will pay for a specific medical service. * **Point of Service (POS):** An option for Prime members to see non-network providers at a much higher cost without a referral. * **PCM (Primary Care Manager):** Your "gatekeeper" in TRICARE Prime who coordinates your care within the network.

## Sources * **TRICARE.mil - Types of Providers:** [https://www.tricare.mil/Providers/TypesofProviders](https://www.tricare.mil/Providers/TypesofProviders) * **Humana Military (East):** [https://www.humanamilitary.com/](https://www.humanamilitary.com/) * **TriWest Healthcare Alliance (West):** [https://www.triwest.com/](https://www.triwest.com/) * **Express Scripts TRICARE Pharmacy:** [https://militaryrx.express-scripts.com/](https://militaryrx.express-scripts.com/)