Your TRICARE benefit: What you need to know
Humana Military is excited to once again serve as the contractor for the TRICARE East Region!
The newest TRICARE contracts begin on January 1, 2025. There will still be two regions in the United States. However, six current East Region states will move to the West Region: Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin. Humana Military will remain the contractor for the TRICARE East Region and TriWest Healthcare Alliance Corporation is the contractor for the West Region.
If you are a beneficiary staying in the East Region, there is no action required on your part! Your TRICARE benefit will remain almost entirely the same as it is now- the only change you’ll see is a new claims processor.
Effective January 1, 2025, PGBA LLC will process claims for the TRICARE East Region. The process for submitting claims will remain the same, but addresses, phone numbers, and other contact information will be change.
If you have any questions in the leadup to January 1, 2025, please visit us online or call us Monday - Friday, 8 AM - 6 PM (ET and CT) at (800) 444-5445.
We look forward to continuing to serve you as part of the TRICARE East Region!
The newest TRICARE contracts begin on January 1, 2025. There will still be two regions in the United States. However, six current East Region states will move to the West Region: Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin. Humana Military will remain the contractor for the TRICARE East Region and TriWest Healthcare Alliance Corporation is the contractor for the West Region.
If you are a resident of one of the six states moving to the West Region, TriWest will be your TRICARE benefit administrator beginning January 1, 2025. Humana Military remains your TRICARE benefit administrator until December 31 for all referrals, billing and network care.
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We are committed to providing a seamless transition for all our beneficiaries, along with support and resources you need to use your new West Region TRICARE benefit.
Referrals and authorizations
Humana Military referrals or authorizations approved for care as of December 31, 2024 will be extended through the expiration date or 180 days into the new year, whichever comes first. You will not experience a disruption in care. If care is continued beyond the expiration or 180 days, your provider will submit a new referral or authorization to TriWest. If your provider does not join the TriWest network, TriWest will review your options with you so you may make the best decision to continue care with a TRICARE provider. For complex and/or high-risk ongoing care, TriWest will work with Humana Military to ensure a smooth transition. For new episodes of care occurring after January 1, 2025, your current Primary Care Manager (PCM) must submit a referral to TriWest prior to seeking care.
Keeping my provider
If you’re enrolled at a military clinic or hospital for primary care, these changes have no effect on your PCM or any specialty care that your enrolled facility provides.
If your PCM is a TRICARE network civilian provider, it’s too early to tell if it will be necessary to obtain a new PCM. Humana Military is working closely with TriWest to keep the provider network in place so that continuity of care may be achieved wherever possible in all six states. TRICARE and TriWest will be very responsive to any concerns you have during transition.
Enrollment fees and premiums
If you pay your enrollment fees or premiums through a military pay system allotment, no action is necessary, as those payments will automatically be transferred to TriWest beginning with your January 2025 payment.
If you pay by credit card or bank Electronic Fund Transfer (EFT), you must provide authorization to TriWest by downloading the Automatic Payment Authorization form at TRICARE.mil/West. Please submit the Automatic Payment Authorization form to ensure uninterrupted payments.
We always encourage payment by allotment whenever possible. You can sign up now and you will not have to take any action in January 2025.
Claims
Beneficiaries moving to the West Region will begin coverage with TriWest on Jan. 1, 2025. Please submit your claims with Date of Service (DOS) prior to Jan. 1, 2025, to Humana Military by Dec. 31, 2024; you can begin to submit your claims to TriWest beginning Jan. 1, 2025. Please verify your claims submitted before January 1, 2025, on the Humana Military portal. For claims submitted after that date, use the TriWest beneficiary portal.
Please note, any payment related issues encountered after January 1 should be directed to TriWest.
Open Season 2024 (November 11 through December 10, 2024)
Open Season 2024 happens November 11 through December 10, 2024 and marks the beginning of your interaction with TriWest as your future TRICARE benefit administrator. You will have access to the following TriWest resources beginning November 11:
To schedule credit card and EFT payments, visit TRICARE.mil/West which launches Oct. 4.*Remember, all active network healthcare will still be managed by Humana Military until December 31.
Together, the DHA, Humana Military and TriWest are dedicated to providing a seamless transition to the West Region for you and your family. Thank you, as always, for entrusting us to take care of you.
If you have any questions in the leadup to January 1, 2025, please visit us online or call us Monday - Friday, 8 AM - 6 PM (ET and CT) at (800) 444-5445.
