What must beneficiaries be aware of if choosing to receive care from non-network providers?

Beneficiaries should be aware that choosing to receive care from non-network providers typically results in higher out-of-pocket expenses. This is due to the way TRICARE cost-sharing works. When beneficiaries utilize network providers, TRICARE has negotiated lower rates, which helps keep costs lower for both the beneficiaries and the plan. However, when they opt for care outside the network, they may be responsible for higher co-pays or percentage payments of the total cost of care, as the reimbursement rates differ for non-network services.

In addition, non-network providers do not have the same agreements with TRICARE, which can lead to a lack of certain negotiated benefits, making the total expense significantly higher. Beneficiaries may also need to file claims on their own for non-network provider services, which can complicate the reimbursement process and lead to further costs if the claims are not processed effectively.