What defines a non-network provider in TRICARE?

A non-network provider in TRICARE is defined as a provider that does not have a contract with TRICARE and may incur higher costs to the beneficiary. This definition is key because non-network providers can often charge more than what TRICARE would reimburse, leading to increased out-of-pocket expenses for the patient. Since they are not part of the TRICARE network, these providers do not have agreed-upon rates, which typically results in higher co-payments and coinsurance for beneficiaries.

In contrast, providers who do have a contract with TRICARE (network providers) have already established negotiated rates that help to minimize beneficiaries' costs. This distinction is crucial for understanding how beneficiaries choose their healthcare options within the TRICARE program. Non-network providers can offer services, but beneficiaries should be aware of the potential for increased healthcare costs when utilizing them.