TRICARE Prime Beneficiaries: Specialty Care Referral Extension Ends Sept. 30

PHOENIX (Sept. 9, 2025) — The Defense Health Agency (DHA) has announced that starting Oct. 1, TRICARE West Region Prime beneficiaries who have been using the referral approval waiver extension, and will continue their specialty care past Sept. 30 will need to get a new referral to a network specialist.

DHA advises Prime beneficiaries who plan to continue their specialty care past Sept. 30 request their primary care managers (PCMs) submit new referrals to TriWest Healthcare Alliance (TriWest) for approval prior to Oct. 1.

DHA also advises Prime beneficiaries to review their current referral information by logging into the TRICARE West Region Beneficiary Portal.

TRICARE Prime Specialty Care Referrals: What to Know

TRICARE Prime PCMs and beneficiaries should be aware of important details and timing related to the Sept. 30 specialty care referral approval waiver deadline.

• Beneficiaries with an active referral for specialty care can keep getting care until Sept. 30, or the authorization expiration date, whichever comes first.
• By Oct. 1, PCMs must submit new referrals to TriWest for a network specialist to continue certain specialty care after Sept 30.
• Failure to get a new referral approval from TriWest may result in out-of-pocket costs.
• Fees may apply for beneficiaries seeing an out-of-network specialist.
• West Region beneficiaries needing new specialty care must have a referral submitted by their PCM for certain types of care.

Read about DHA’s referral approval waiver deadline in this new TRICARE Newsroom article on how some TRICARE West Region Prime beneficiaries may need new specialty care referrals before Oct. 1.