In what scenario would a beneficiary face higher costs in TRICARE?

In what scenario would a beneficiary face higher costs in TRICARE?

• A. Seeing a primary care manager
• B. Utilizing a non-network provider
• C. Receiving care in a network hospital
• D. Getting care from TRICARE Prime providers

Answer: (B)

A beneficiary would face higher costs when utilizing a non-network provider because non-network providers do not have an agreement with TRICARE that dictates set reimbursement rates. As a result, the beneficiary may be responsible for a larger portion of the costs, including deductibles and copayments, compared to using network providers who have established rates with TRICARE. In contrast, seeing a primary care manager, receiving care in a network hospital, or getting care from TRICARE Prime providers typically results in lower out-of-pocket expenses due to the pre-negotiated rates and cost-sharing arrangements that favor beneficiaries within the network.

A beneficiary would face higher costs when utilizing a non-network provider because non-network providers do not have an agreement with TRICARE that dictates set reimbursement rates. As a result, the beneficiary may be responsible for a larger portion of the costs, including deductibles and copayments, compared to using network providers who have established rates with TRICARE. In contrast, seeing a primary care manager, receiving care in a network hospital, or getting care from TRICARE Prime providers typically results in lower out-of-pocket expenses due to the pre-negotiated rates and cost-sharing arrangements that favor beneficiaries within the network.