January 26, 2025 - 05:21

Attention TRICARE Prime enrollees! A significant change has been announced regarding the referral process for outpatient specialty care in the West region. The Defense Health Agency has waived the requirement for pre-authorization, which means that TRICARE-authorized specialty care providers can now offer services without waiting for approval from TriWest for referrals issued by your primary care manager.
This adjustment aims to streamline access to necessary medical care, allowing patients to receive timely treatment. However, it is important to note that enrollees must still obtain a referral from their Primary Care Manager before seeking specialty care. This new process is effective retroactively from January 1, 2025, and will remain in place until March 31.
This waiver is expected to enhance the overall healthcare experience for TRICARE Prime enrollees by reducing delays in receiving specialized medical attention. Stay informed and ensure you follow the necessary steps to access your care.