Call Your Regional Contractor First when Getting Specialty Care
/ Published July 07, 2016
FALLS CHURCH, Va. -- TRICARE beneficiaries with special needs or a serious illness or injury have several resources available for help. Your care is best coordinated through your regional contractor.
TRICARE rules require that if the care you need is available at a military hospital or clinic near you, and there is space available, you will be referred there first. However, if the care you need is not available, you will be referred to a network provider near you.
It is important to call and remain in contact with your regional contractor. Your regional contractor will have the most up-to-date list of providers and know which of those providers have wait lists. If you contact a specialty care provider directly, you could be on a wait list instead of getting the care you or a family member needs.
When you get your referral, your regional contractor will send a letter with the name and location of your specialty provider. The letter will also tell you what care is authorized, the length of time you are authorized to receive that care, and the type and number of visits you are allowed before you need another referral. If you would like a provider that is different than the one provided in your letter, you must call your regional contractor.
Family members with special needs require special considerations. There are resources and information available to help you get the care your family needs. However, you must contact your regional contractor to make sure you have access to the most current list of providers and have the most current information about those providers.
You can reach your contractor by phone. Health Net is the north region contractor and can be reached at 1-877-874-2273. Human Military is the contractor for the south region and can be reached at 1-800-444-5445. The west region contractor is UnitedHealthcare. They can be reached at 1-877-988-9378. If you don’t know which region you’re in, please visit the TRICARE website.