What is TRICARE?
TRICARE is the uniformed services health care program for active duty service members (ADSM), active duty family members (ADFM), National Guard and Reserve members and their family members, retirees and retiree family members, survivors, and certain former spouses worldwide.
TriWest Healthcare Alliance (TriWest) holds the contract to administer the U.S. Department of Defense’s (DOD) 26-state TRICARE West Region with health care delivery (dates of service) scheduled to begin January 2025.
TRICARE brings together the health care resources of the Military Health System with a network of civilian health care professionals, institutions, pharmacies, and suppliers to foster, protect, sustain, and restore health for those entrusted to their care.
Join the TriWest Provider Network
To prepare for health care delivery under TRICARE in 2025, TriWest is now accepting interest forms from providers who wish to join the TriWest network.
- Go to JoinOurNetwork.TriWest.com.
- Fill out the Provider Contract Request form. Note: You will need your Federal Tax ID.
- Allow the TriWest team time to process requests and then you will be contacted by one of our provider relations representatives.
TriWest has started the process of notifying both future interested providers and current network providers about their contract status. This process is expected to take several months to complete. Once your contract is fully processed, you will receive a copy of your executed agreement.
Have contract questions? Check out the Provider Contracting Q&A section.
TriWest’s provider contracting team looks forward to working with you.
TRICARE West Region Coverage Area
TriWest will team with a network of providers for the Department of Defense’s TRICARE West Region. Health care delivery is expected to start on January 1, 2025. The new TRICARE West Region covers 26 states: Alaska, Arkansas, Arizona, California, Colorado, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin, and Wyoming.
Different Contracts: TRICARE and VA Community Care Network
TriWest Healthcare Alliance holds three contracts with the federal government for providing access to care – the Department of Veterans Affairs (VA) Community Care Network (CCN) Regions 4 and 5, and the Department of Defense (DOD) next generation TRICARE West Region. What is the difference between VA CCN and TRICARE?
TRICARE
- TRICARE is the DOD health benefit.
- It brings together military and civilian health care professionals and resources to provide high-quality health care services to TRICARE-eligible beneficiaries: enrolled active duty service members, active duty family members, National Guard and Reserve members and their families, military retirees and families, survivors and certain former spouses.
- TriWest is the DOD’s managed care support contractor for the next generation TRICARE West Region.
- The DOD relies on managed care support contractors to develop and administer regional networks of high-performing, licensed, and contracted health care providers to care for military families.
- The TRICARE West Region includes 26 states: Alaska, Arkansas, Arizona, California, Colorado, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin, and Wyoming.
- TRICARE is managed by support contractors in two stateside regions: TRICARE East and TRICARE West. In these regions, The Defense Health Agency (DHA) oversees the TRICARE program.
- The DOD DHA has contracted with TriWest Healthcare Alliance to assist TRICARE regional directors and military hospital commanders in operating an integrated health care delivery system in the new West Region. Note: For the next generation of TRICARE, the TRICARE East Region managed care support will remain Humana Military.
- TriWest’s claims processor for the next generation TRICARE West Region will be PGBA.
- Health care delivery (date of service) is expected to begin in the next generation TRICARE West Region on January 1, 2025.
VA Community Care Network
- VA purchases care in the community to ensure Veterans receive the health care services they need and deserve. The consolidated approach to purchasing this care is through the Community Care Network, or CCN.
- VA relies on the third party administrators to develop and administer regional networks of high-performing, licensed, and contracted health care providers to care for Veterans.
- CCN covers all U.S. states and territories.
- TriWest is VA’s third party administrator for CCN Regions 4 and 5.
- CCN Region 4 includes 13 states and the U.S. Pacific Territories: American Samoa, Arizona, California, Colorado, Guam, Hawaii, Idaho, Montana, Nevada, New Mexico, Northern Mariana Islands, Oregon, Texas, Utah, Washington, and Wyoming.
- CCN Region 5 includes the state of Alaska.
- Health care delivery is currently underway through VA CCN throughout Regions 4 and 5. TriWest’s claims processor for VA CCN Regions 4 and 5 is PGBA.
TriWest Will Manage the TRICARE West Contract
While the names sound alike, TRICARE West and TriWest are NOT the same. Read about the key differences between TRICARE West and TriWest below.
TRICARE brings together military and civilian health care professionals and resources to provide high-quality health care services.
TriWest serves the health care needs of the military and Veteran communities by managing contracts such as the DOD’s TRICARE program and VA’s Community Care Network.
TRICARE West is the region of the TRICARE program being managed by TriWest and includes 26 states.
Since our founding in 1996, TriWest Healthcare Alliance has been On a Mission to Serve® our nation’s military and Veteran communities.
TRICARE is managed by support contractors in two regions: TRICARE East and TRICARE West. In these regions, the Defense Health Agency (DHA) oversees the TRICARE program.
TriWest previously administered the Department of Defense TRICARE program in the West Region from 1996–2013.
The Defense Health Agency has contracted with TriWest Healthcare Alliance to assist TRICARE regional directors and military hospital commanders in operating an integrated health care delivery system in the new West Region with health care delivery expected to begin January 1, 2025.
TriWest is also the Department of Veterans Affairs third-party administrator for VA’s Community Care Network in Regions 4 and 5.
2025 TRICARE West Region Provider Handbook
Thank you for your interest in joining the TriWest provider network to deliver the highest level of care for our military personnel and their families. We are so grateful for our team of medical professionals taking care of our nation’s heroes – and now their families, too.
This TRICARE Provider Handbook applies to TriWest network providers in the 26-state TRICARE West Region (blue states on map above) who will provide health care services to TRICARE-eligible beneficiaries at the start of health care delivery in January 2025.
Have questions about the TRICARE contract or how to join the TriWest provider network? Call 866-690-0885 to speak to a Provider Relations representative.