FALLS CHURCH, Va. –
*Note: This article was updated April 29 to reflect the extension of the referral approval waiver through June 30 and the point-of-service fee waiver through Sept. 30.*
IMPORTANT: Do you currently live in the West Region? Or, do you live in one of the six states (Arkansas, Illinois, Louisiana, Oklahoma, Texas, Wisconsin) that moved to the West Region on Jan. 1 as part of TRICARE’s new regional contracts?
Do you pay for your TRICARE coverage using a bank electronic funds transfer, credit card, or debit card? If so, and you haven’t done so already, you must securely provide your recurring payment information to the West Region contractor, TriWest Healthcare Alliance. You have until Wednesday, April 30 to submit your payment.
If you don’t act, you’ll be disenrolled, retroactive to your paid-through date.
“We want to ensure that anyone who wants to keep their TRICARE coverage remains enrolled in their plan,” said Malcolm Jones, enrollment and billing specialist, TRICARE Health Plan, at the Defense Health Agency. “You must take action and submit your payment now to ensure that TRICARE can continue to support your healthcare needs.”
If you have TRICARE Prime, you should also know that DHA has extended the West Region referral approval waiver through June 30. This means TRICARE-authorized specialty care providers don’t need to wait for TriWest to approve referrals issued by your primary care manager before providing outpatient care.
Keep reading to learn more about what you may need to do by April 30.
Submit payments
If you don’t make a payment to TriWest by April 30, you’ll be disenrolled from your TRICARE health plan. If you haven’t made any payments for coverage this year, your disenrollment will date back to Jan. 1. This means you’ll be responsible for paying the full cost of any healthcare services you or your family have received this year.
Have you already made payments to TriWest? Or do you automatically pay for your coverage by military pay system allotment? You should check your payment method before April 30 to confirm that your payments:
- Have successfully been taken from your account
- Are the correct amount
If you notice any issues with your payment amount or payment method, call TriWest customer service at 888-TRIWEST (874-9378).
You don’t need to take any action if you:
- Have TRICARE For Life, the US Family Health Plan, or a TRICARE health plan overseas. The new contracts don’t affect you.
- Live in a state that’s staying in the East Region. You don’t need to do anything, because Humana Military has kept your current payment information on file. If you live in the East Region and have questions for Humana Military, you can call them at 800-444-5445.
- Don’t pay enrollment fees or premiums for your TRICARE coverage. Examples include active duty service members and their family members.
How to set up your payments
The easiest and fastest way to set up your payments with TriWest is through their
secure portal.
- Visit the TriWest portal.
- Select the “New User? Sign Up Now” option.
- You’ll be asked to input your email address. A verification code will be sent to you by email.
- Check your email for the verification code and enter it to continue.
- Be sure to enter the correct Benefits Number when asked. Enter your Benefits Number without dashes. You can find your 11-digit Benefits Number from the back of your Uniformed Services ID card. (See Showing Your ID to Providers to locate your Benefits Number on your ID card. It provides a picture graph of ID and CAC cards showing your Benefits Number, which is different from your DOD ID number.)
- Complete the information requested (name, address, etc.) in the secure forms.
- Select your payment method.
- Complete all fields.
- Submit.
You can also download the Automatic Monthly TRICARE Payment Set Up Request form, located on www.tricare.mil/west. Complete the form and mail it to the address on page 2. This form is for recurring monthly payments.
If you run into any issues with these options, you can call TriWest customer service at 888-TRIWEST (874-9378) and provide your payment information over the phone.
Act now to avoid being disenrolled from your TRICARE health plan on May 1, with an effective date of Jan. 1.
Referral approval waiver extended through June 30 for TRICARE Prime
DHA has extended the West Region referral approval waiver. Through June 30, you should continue following the rules of your TRICARE Prime plan, as described in the
TRICARE Choices in the United States Handbook.
You can continue seeing your PCM to get referrals for specialty care—even if your PCM is not currently in TriWest’s network. (Note: Point-of-service fees are also waived for existing referrals with providers who are now non-network in the West Region through Sept. 30.)
During the waiver period, you don’t need to wait for the contractor to approve your referral, regardless of the PCM's location (office, urgent care, etc.). However, the specialist you see must be TRICARE-authorized.
Remember: This waiver doesn’t apply to:
To learn more, including what to bring to your specialist appointment, check out the article “Defense Health Agency Announces TRICARE West Region Referral Approval Waiver” on the TRICARE Newsroom.
Do you have questions about referrals, authorizations, or other parts of the West Region transition? Visit TRICARE West Region Transition to learn whom to contact with your questions.