FALLS CHURCH, Virginia –
The new year has begun. It’s a great time to renew focus on your health. Did you put off seeing a doctor in 2021? If so, now is your time to act. Regular checkups are critical to screening for diseases and preventing future health problems and TRICARE is here to help you find the right doctor.
“With TRICARE, you may get care from a military hospital or clinic, or from a civilian TRICARE-authorized provider,” said Curt Prichard, deputy chief of TRICARE Health Plan at the Defense Health Agency. “Your coverage enables you to visit different types of civilian providers, but a TRICARE network provider is your most cost-effective option.”
Would you like to know more about network providers? Here are some helpful answers to questions you may have.
Q: What are some advantages of using a TRICARE-authorized network provider?
A: There are two types of TRICARE-authorized providers: network and non-network. If you’re looking for medical care outside of a military hospital or clinic, you may have the option of visiting either provider. It all depends on your health plan and the type of care you need. But choosing a network provider may minimize your out-of-pocket costs. Network providers have agreed to accept the contracted rate as payment in full for covered health care services. Network providers will also file claims for you so you don’t have to.
If you live overseas, network providers also have an agreement with the TRICARE overseas contractor. As outlined in the TRICARE Overseas Program Handbook, they agree to provide cashless and claimless services to those in TRICARE Overseas Program (TOP) Prime and TOP Prime Remote. But keep in mind, network providers don’t have to file claims for those enrolled in TOP Select.
Q: How can I find a TRICARE-authorized network provider?
A: The TRICARE contractors have established provider networks in each region. You can use the Find a Doctor tool to find a provider. You can also go directly to your TRICARE contractor’s network provider directory and search for a TRICARE provider in your area:
Do you live or travel in the Philippines? If yes, use the Philippine Provider Search tool to locate a provider near you. Keep in mind, you must see a Philippine Preferred Provider Network provider or certified provider.
Q: How can I find a TRICARE-authorized mental health network provider?
A: The TRICARE contractors have established provider networks in each region to include mental health providers. You can go directly to your TRICARE contractor’s network provider directory to find a TRICARE mental health provider in your area:
You don’t need to get a referral or pre-authorization for any outpatient mental health (except psychoanalysis) and substance use disorder care. This includes services, like therapy and counseling. If you choose a provider outside the network, you may pay higher costs.
Did you know that you have the option to use telemental health services as part of your TRICARE benefit? Your regional contractor has a network of providers who provide telemedicine that you can choose from. Telemedicine can be done using live audio and video or audio-only services. You can search for a telemental health provider on your TRICARE contractor’s network provider directory. Or, you can call to request telemental health services or other types of mental health services.
Keep in mind, if you’re an active duty service member and seek care in the TRICARE network, you must get a referral and pre-authorization. You don’t need a referral or pre-authorization if you seek outpatient mental health services at a military hospital or clinic.
Q: What provider options do I have if I’m covered by TRICARE For Life?
A: Your provider options differ if you have TRICARE For Life (TFL). Remember that TFL coverage is automatic for beneficiaries age 65 and older, who have both Medicare Part A and Part B. With TFL, you may get care from Medicare participating, Medicare non-participating, or opt-out providers.
To find a Medicare provider:
As you search for a provider who meets your needs, remember you’ll need to follow your plan’s rules for referrals and pre-authorizations when seeking care. Some services may require a referral or pre-authorization depending on your health plan. To learn more about your coverage, visit the Health Plans page and choose your plan. If you have questions about your provider options, reach out to your TRICARE contractor.
Get this year off on the right foot by choosing a network provider and getting your checkup.