TRICARE West for Beneficiaries
Prime Referral Waiver Ends
Prime Rules Apply as of April 16
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We offer many self-service tools on our website you can use to assist with your TRICARE transactions, as well as general information should you have questions about the recent changes to TRICARE.
You can also use our Interactive Voice Response system for certain transactions, such as checking eligibility and making enrollment payments, rather than waiting on hold. Tip: If you have background noise when using the IVR, mute your phone and key in your responses.
Five things to know
- The TRICARE Prime Referral Waiver period has ended. Care approved under the waiver is valid through June 30, 2018 (or through postpartum care).
- TRICARE Prime beneficiaries whose previous UnitedHealthcare Military & Veterans (UnitedHealthcare) primary care managers (PCM) are not in the HNFS West Region Network Directory, or who have not yet been assigned a PCM, can see any non-network TRICARE-authorized PCM through June 30, 2018, and Point of Service charges will not apply.
Beneficiaries enrolled in TRICARE Select can see any TRICARE-authorized provider (network or non-network), however, out-of-pocket costs will vary based on the provider's network status.
- HNFS continues to honor active authorizations and referrals issued by UnitedHealthcare that extend into 2018, even if the servicing provider is not part of the HNFS West Region network. No action is required by you, and you do not need a separate approval letter from HNFS. TRICARE Prime beneficiaries who choose to see a different civilian provider than the one authorized by UnitedHealthcare, may see any network or non-network provider of that specialty. Keep in mind, Point of Service charges will apply after June 30, 2018, should you continue care with a non-network provider without HNFS approval.
- TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult: Enrollment payments must be made via an automated method. Learn more about enrollment payments.
- Use the nomination form within the network directory if you'd like us to contact a doctor about joining our network.
Visit www.tricare.mil/changes often for detailed information on the recent changes and to sign up for email alerts.