When receiving care from a non-network, non-participating provider, up to what percentage may a beneficiary have to pay above the TRICARE-allowable charge?

When beneficiaries receive care from a non-network, non-participating provider, they may be responsible for paying a percentage above the TRICARE-allowable charge due to the absence of a contractual agreement between TRICARE and the provider. In this scenario, the beneficiary could end up paying up to 15% above the TRICARE-allowable charge. This percentage reflects the additional costs incurred when seeking care from providers outside the TRICARE network. Such costs are essential for beneficiaries to consider when choosing their healthcare providers, as they directly affect out-of-pocket expenses and overall healthcare budget planning. Understanding this percentage helps beneficiaries make informed decisions about their healthcare options and anticipate potential extra costs associated with non-participating providers.