01/22/2025
TriWest Health Alliance Updates
Attention TRICRE Beneficiaries:
We are fully aware of the challenges associated with the new Managed Care Support Contractor (MCSC), TriWest Health Alliance. Please rest assured that our command is working diligently to assist beneficiaries in addressing these issues.
Below, you will find key concerns raised by TRICARE beneficiaries, along with an official statement from the Defense Health Agency (DHA).
For additional support, our command has a dedicated TRICARE Liaison Officer available to address your questions and concerns. They are committed to assisting you and can be reached at 361-961-2810 or 361-945-8702.
Thank you for your continued patience and understanding during this transition.
Payment:
The Defense Health Agency is committed to putting our patients first and making every effort to ensure no one loses their health plan coverage. We recognize that call center hold times and web-based portals have created challenges for beneficiaries to update premium payment information in a timely manner. For all premium based plans, the DHA has extended the deadline for payment update to February 28th. We urge beneficiaries to take action now through the TriWest portal or TriWest call center at 888-TRIWEST (874-9378), as needed. We are committed to preventing any disruption to beneficiary healthcare coverage and maintaining the high level of service our TRICARE members deserve. No beneficiaries will be disenrolled from TRICARE until DHA reviews each case and concurs with the action.
Call Center Wait Times:
The Defense Health Agency is aware that TRICARE beneficiaries transitioning in the West are experiencing significant call wait times. The Defense Health Agency is working with TriWest to reduce wait times and ensure TRICARE beneficiaries have the support they need to transfer payment information to maintain health care coverage. TriWest is bringing on additional staff to reduce wait time and ensure that TRICARE beneficiaries have the support they need to get their questions answered and to ensure transfer of payments, as required. We appreciate your patience and understanding as we navigate this transition.
Referrals:
The Defense Health Agency knows many beneficiaries have active referrals in the West Region that have not been authorized by TriWest. All active referrals and pre-authorizations from the previous contractors (Health Net Federal Services or Humana) that were issued before Jan. 1, 2025, will be honored by TriWest and will be valid through their expiration or June 30, 2025, whichever comes first. Our TRICARE Health Plan team is working directly with TriWest to actively process all existing referrals. You can check your referral status or get assistance by visiting the TriWest online or calling 888-874-9378.
Claims Questions
Please be aware that HealthNet Federal Services and Humana Military (in the six States that moved to the west region) can no longer assist beneficiaries in the west region with questions about healthcare service received or claims submitted January 1, 2025 or later. The only support HealthNet can now provide relates to claims from services provided prior to January 1. If you have a question about a claim for care received before January 1, 2025, you may call HealthNet Federal Services at 1-844-866-WEST (1-844-866-9378) or Humana Military at 1-800-444-5445. For all questions regarding claims submitted after January 1, 2025, beneficiaries should reach out to TriWest for assistance by visiting the TriWest online or calling 888-874-9378.
NAS JRB Fort Worth
