Editor’s Note: This article is part of MOAA’s 2026-27 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2026 issue of Military Officer magazine. 

Whether you’re retired or still serving, TRICARE remains one of the most valuable benefits of military service. As with any health coverage, your total costs can depend on how well you understand your coverage. Indeed, knowing how a provider works with your TRICARE plan can save you money and prevent unpleasant surprises.

A TRICARE provider is anyone who is providing health care, medications, or medical supplies. This includes doctors, hospitals, imaging centers, labs, pharmacies, and medical equipment companies. Each provider is classified based on their relationship with TRICARE. There are three levels of these relationships, and each level sits inside the previous level.

At the highest level, every provider must be certified by TRICARE, meaning they are TRICARE-authorized providers. They must also apply and meet program requirements. TRICARE will not pay for care from providers who have not completed this process. Within TRICARE-authorized providers, they may be a network provider or a non-network provider.

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Network providers are authorized providers who have a written agreement with the TRICARE regional contractor. These contractors are Humana Military for the East Region and TriWest for the West Region. They have agreed to accept TRICARE’s negotiated rate as payment in full. They will file claims for the beneficiary and collect their payment directly from TRICARE.

Non-network providers are authorized providers who don’t have a written agreement regarding claims and payments. Non-network providers fall into two groups: participating and nonparticipating.

A participating non-network provider voluntarily accepts TRICARE’s allowable charge as payment in full. They will file your claims for you and accept payment directly from TRICARE. This works similarly to using a network provider, except that this approach does not fulfill the network requirements for TRICARE Prime beneficiaries.

A nonparticipating provider may require you to pay up front, and they typically do not file claims for you. Nonparticipating providers may legally charge up to 15% above the TRICARE-allowable amount — an amount for which you are responsible.

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If you use TRICARE Prime, you must use a network provider to receive full coverage for your care. Care received by TRICARE Prime beneficiaries from non-network providers is reimbursed at the lower point-of-service rate, which will substantially increase your medical costs.

If you use TRICARE Select, you may receive care from a network provider or a non-network provider. Your out-of-pocket cost will vary based on the provider’s classification. It’s worth noting that network status doesn’t guarantee the lowest cost; non-network providers can sometimes be cheaper.

Before receiving care, verify that your provider meets the requirements of your TRICARE plan. Start by checking whether they are a TRICARE-authorized provider, then ask whether they are a network or non-network provider. If you’re on TRICARE Select, and if they are a non-network provider, inquire whether they are a participating or non-participating provider.

Your provider’s relationship with TRICARE impacts how much and when you pay, plus who files the claims. Understanding the provider types can ensure you never pay more than expected.