TRICARE West for Providers
Prime Referral Waiver
Referrals Waived Jan. 1–March 18
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Due to the TRICARE changes that went into effect Jan. 1, 2018, we currently are experiencing high call volumes. 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. We appreciate your patience.
Five Things to Know
- The Defense Health Agency has waived referral and authorization requirements for TRICARE West Region beneficiaries enrolled in a TRICARE Prime plan. Learn how to initiate care on our TRICARE Prime Referral Waiver page.
- Health Net Federal Services, LLC (HNFS) will honor referrals and authorizations issued by UnitedHealthcare Military & Veterans (UnitedHealthcare) through their 2018 expiration dates, even if the servicing provider is not a part of the HNFS West Region network. 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 March 31, 2018, should the beneficiary choose a non-network provider.
- TRICARE Prime beneficiaries whose 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 March 31, 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.
- Active UnitedHealthcare authorizations are loaded in our system for accurate claims processing and visible through our online authorization tools.
- If you have recently completed our HNFS West Region Network Provider Participation Packet and would like status, you can check credentialing status online. Please keep in mind the full credentialing process may take 60–90 days from the time we receive a complete application. HNFS will notify you once credentialing is completed.