Defense Health Agency Extends Tricare West Deadlines Amid Transition Issues

The Defense Health Agency (DHA) has once more prolonged essential deadlines for Tricare West Region patients, granting them until April 30 to revise payment information, obtain specialty care without prior authorization, and seek care from non-network providers. The extension arrives in the context of ongoing challenges that have emerged since the January 1 transition to TriWest Healthcare Alliance as the new Tricare West contractor.

The deadline for payment updates is relevant for patients who are making payments to TriWest via bank draft or credit card. The deadline, initially set for Dec. 31, has been extended several times because of persistent challenges related to account transitions. Enrollees in Tricare Young Adult, Tricare Reserve Select, and Tricare Retired Reserve must update their payment information by April 30 to avoid retroactive disenrollment to January 1.

A significant addition pertains to specialty care referrals for Tricare Prime beneficiaries. Patients must secure referrals from their primary care providers; however, TriWest approval will not be necessary until after April 30. This waiver excludes inpatient care, autism services, lab tests, and Extended Care Health Option services.

Furthermore, the point-of-service waiver will stay in effect until April 30, enabling patients to keep seeing non-network providers previously part of the Health Net Federal Services network. Nonetheless, patients are required to pay any relevant copayments and confirm if their provider is authorized by Tricare.

TriWest received a 9-year contract valued at $65 billion to oversee health care for 4.5 million beneficiaries in the Tricare West Region. The shift from Health Net Federal Services has led to some confusion for both patients and providers. Several providers were not informed about the contract change, resulting in worries regarding the continuity of care.

Tricare West beneficiaries can find additional information by visiting the Tricare West Region website.