By MOAA Staff

Note: TRICARE For Life beneficiaries and those with coverage under the US Family Health Plan are not affected by the TRICARE West Region transition to TriWest and do not need to provide payment information to the new regional contractor. If you’re enrolled in TRICARE Prime or Select as a retiree family or purchase TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE Young Adult in the West Region, you may need to act to avoid losing coverage; click here for details.

The recent TRICARE West Region changeover has resulted in several reported issues with beneficiary care and billing:

• Some beneficiaries have reported problems setting up payments and reaching TriWest customer service staff.
• Some reserve-component beneficiaries have been asked to pay between $600 and $1,500 a month to retain coverage – an errant notification since corrected by TriWest.
• The former West Region contractor, Health Net Federal Services, reportedly has been swamped by “misdirected calls” seeking TRICARE support, including some forwarded its way by the current contractor.

TriWest has pledged to make improvements to its customer service and address the high complaint volume, in addition to other policies already in place to ease the transition: A 90-day network waiver for providers (through March 31), for example, and the honoring of preauthorized referrals from Health Net through June 30 or the referral/preauthorization expiration date, whichever comes first.

MOAA remains in contact with Defense Health Agency (DHA) officials and contractors to monitor this transition, make our members aware of any coverage changes or updates, and ensure continued access to service-earned health care. We have been tracking this issue since long before the changeover, spearheading a 2021 letter from The Military Coalition (TMC) to House and Senate Armed Services Committee leaders about potential disruptions and a 2024 TMC letter to DoD health care leaders urging them to issue guidance designed to minimize transition disruptions.

Since learning about beneficiary challenges in the West Region, MOAA has asked DHA to institute a specialty care referral waiver, as has been done during previous TRICARE contractor transitions. This would allow TRICARE Prime beneficiaries to temporarily seek specialty care without a referral to streamline access to care during the transition disruption.

MOAA has also met with TriWest leadership to share concerns about beneficiary access to care and the quality of provider networks.

If your care has been disrupted as a result of this changeover, please contact MOAA at legis@moaa.org. Below, find some resources addressing common challenges associated with the changeover.

Method of Payment Updates

What: TRICARE West Region beneficiaries received extensions to update their credit/debit/electronic funds transfer payment information with TriWest, but those who do not make the updates could be disenrolled back to Jan. 1 after the new deadlines expire.

Who: Retirees in TRICARE Prime or Select who have not updated their payment information were given an extension until Jan. 30, while beneficiaries enrolled in TRICARE Young Adult, TRICARE Reserve Select, or TRICARE Retired Reserve have until Feb. 7. This update does not apply to those who pay by military allotment, or to TRICARE For Life beneficiaries.

How: Health.mil offers full instructions on making the update via the TriWest online portal. Beneficiaries who cannot access the portal or have additional questions can call TriWest at 1 (888) 874-9378 to provide payment details over the phone.

Claims and Care Questions

What: Finding answers to your care-related questions will depend on when care was provided. Reaching out to the wrong contractor can result in confusion or more time on hold (or both).

Who: West Region beneficiaries with questions about claims or care received prior to Jan. 1, 2025, can continue to contact the Health Net Federal Services customer support team through March 30. Questions about care in 2025 should go to TriWest.

How: Find more details and contact information from Health Net (pre-2025) at TRICARE-West.com. Connect with TriWest (2025 and forward) at TRICARE.mil/West.

Finding a Provider

What: While DHA told Military.com that more than 90% of primary care providers carried over into the TriWest provider network in 2025, some beneficiaries and providers faced uncertainty as the new contractor took over. 

Who: Beneficiaries whose providers are not part of the TriWest network can continue to see those providers until March 31 without paying out-of-network costs. After that, visits would be more expensive.

How: Check the TRICARE West provider directory to see whether your provider is in the network. If your provider is interested in joining the network, they can find details on the process at this link.