What distinguishes the cost-shares for TRICARE Select in-network versus out-of-network?

In TRICARE Select, the distinction between in-network and out-of-network cost-shares is significant. In-network cost-shares are typically lower because TRICARE has established partnerships with certain healthcare providers who agree to provide services at reduced rates for TRICARE beneficiaries. These providers are known as in-network providers, and their participation leads to lower costs for the patients.

When beneficiaries choose to receive care from in-network providers, they benefit from predetermined cost-sharing amounts that are designed to make healthcare more affordable and accessible. This encourages the use of in-network services and fosters a coordinated care environment where costs are kept manageable for both the beneficiary and the overall TRICARE program.

In contrast, out-of-network care usually involves higher cost-shares. This is because out-of-network providers do not have agreements with TRICARE regarding service rates, which can lead to higher expenses for beneficiaries. This structure incentivizes beneficiaries to use in-network providers when possible to take advantage of the cost savings offered.

Recognizing the cost differentials between in-network and out-of-network care helps TRICARE beneficiaries make informed choices about their healthcare options.