Choosing A TRICARE Provider

Medical care providers under TRICARE include participating, non-participating, network and non-network providers.

Beginning September 1, 2004, all Medicare certified providers who are recognized as a provider class under TRICARE are considered TRICARE authorized providers.

TRICARE authorized providers must be:


• Licensed by their state
   
• Accredited by a national organization (if one exists)
   
• Meet other standards of the medical community
   
• Certified by the TRICARE regional contractor before they can pay for covered services
   
• Fall into one of the categories of health care centers (facilities) or individual providers

Under TRICARE Standard, care must be obtained from a TRICARE-authorized doctor, hospital or pharmacy. TRICARE does not pay for the services of a non- authorized provider.

To select a health care provider, beneficiaries should use their usual means, e.g. obtain recommendations from a friend, family member or coworker, and call the TRICARE Service Center (TSC) or simply call providers listed in the Telephone Directory.

To determine if the provider is TRICARE authorized, beneficiaries should ask the provider or contact the TSC for their region.