Prior Authorization, Referral and Benefit Tool

The Prior Authorization, Referral and Benefit Tool allows you to easily determine:

  • approval requirements from Health Net Federal Services, LLC (HNFS)
  • benefit limitations and
  • how to locate applicable copayments or cost-shares.

Click on the link below to enter the tool. Select the beneficiary's TRICARE plan option (for example, TRICARE Prime or TRICARE Prime Remote), the beneficiary type (for example, active duty service member), servicing provider type (for example, network or non-network) and the specific service being requested. If you are unsure of the type of service, please follow up with your provider for assistance in determining the type of care you need.

This tool only identifies whether a HNFS approval is needed. It does not provide the approval. If it is determined that an approval is needed, please follow up with your provider so he/she can submit the request for review.