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TRICARE Contract Transition

Are you a current or potential TRICARE provider? Here are some frequently asked questions about the upcoming TRICARE contract transition.

Q1:

What's changing?

A:

In the West Region, TriWest Healthcare Alliance will replace Health Net Federal Services, LLC as the regional contractor.

In the East Region, Humana Military will remain the regional contractor. But on Jan. 1, 2025, six states currently in the East Region will move to the West Region.

These states are:

  • Arkansas
  • Illinois
  • Louisiana
  • Oklahoma
  • Texas
  • Wisconsin

Q2:

As a TRICARE provider, do I need to do anything?

A:

The new TRICARE contract doesn’t change the existing TRICARE benefit or how beneficiaries get care.

If you’re a provider in the East Region, no action is needed.

If you’re a West Region provider, or practice in one of the six East Region states transferring to the West Region, find out how to join the TriWest provider netowrk.

Q3:

Do my TRICARE patients need to do anything?

A:

TRICARE beneficiaries are encouraged to make sure their information is current in the Defense Enrollment Eligibility Reporting System. This will help make sure they don’t miss important updates about their benefit and upcoming changes from the Defense Health Agency and TRICARE regional contractors.

Beneficiaries don’t need to take any other action at this time. The TRICARE benefit and how they get care will not change for the rest of calendar year 2024.

Q4:

How will beneficiaries and providers get updates about this transition?

A:

DHA and the TRICARE regional contractors will send updates throughout the year explaining the transition process and any necessary steps to keep TRICARE benefits.

Sign up for email alerts from TRICARE to get the latest information about T-5.

Q5:

Will my patients be able to stay with their current providers?

A:

Humana Military and TriWest will publish their provider directories in November 2024. Providers with established patient relationships may choose to notify beneficiaries about their network status.

Q6:

How can I stay in or join the West Region Network?

A:

If you're currently in the West Region, you'll need to contact TriWest about joining their network.

Q7:

How will this change impact scheduled care for my TRICARE patients?

A:

If you’re a provider in the East or Overseas Regions, your patients’ scheduled care won’t be affected.

If you’re a West Region provider, TriWest will honor HNFS-approved referrals and authorizations for their duration.

Q8:

Will beneficiaries pay more to stay with their current providers

A:

The standards for copays or cost shares don't change due to the new T-5 contract. Beneficiaries’ out-of-pocket costs depend on their TRICARE plan and whether their provider chooses to stay in the TRICARE network as a networknon-network/participating, or non-network/non-participating provider.

Q9:

Will beneficiaries need to re-enroll for their benefits?

A:

No. If they’re currently eligible and enrolled in a TRICARE plan, their TRICARE coverage will continue without interruption. Beneficiaries can make enrollment changes during the next TRICARE Open Season, with changes effective Jan. 1, 2025.

Beneficiaries are encouraged to check DEERS to make sure their information is current. This will help them get important TRICARE updates.

Last Updated: August 13, 2024
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