Is TriWest and Tricare West the same?
Asked by: Glen Lehner | Last update: January 7, 2026Score: 4.9/5 (72 votes)
Is there a difference between TRICARE and TriWest?
In short, TRICARE covers active duty service members, retirees, and their family members. TriWest covers veterans and certain members of the National Guard and Reserves. This difference can become confusing because people sometimes mistake “retiree” for meaning the same thing as “veteran”.
What insurance is TriWest?
TriWest Healthcare Alliance is a Phoenix, Arizona based corporation that manages health benefits under the United States Department of Veterans Affairs (VA) VAPCCC program in Regions 3, 5, and 6. On October 1, 2018, TriWest's contract for VAPCCC was expanded to cover Regions 1, 2, and 4.
What is TRICARE West also known as?
TRICARE West Region (HNFS)
On Jan. 1, 2025, the TRICARE West Region contractor changed from Health Net Federal Services, LLC (HNFS) to TriWest Healthcare Alliance (TriWest), who is now responsible for providing health care to the military community in the TRICARE West Region.
Who uses TriWest?
TriWest is privileged to serve Veterans by connecting them to convenient, high-quality health care they deserve. We partner with VA to serve the health care needs of Veterans in 14 western states and the U.S. Pacific Island Territories under VA Community Care Network Regions 4 and 5.
How the Tricare West and TriWest Change Affects Your Practice
Is TriWest only for veterans?
Founded in 1996, TriWest Healthcare Alliance (TriWest) is the only company of its kind with one sole purpose that continues today – serving the health care needs of the nation's military and Veteran communities.
Who owns TriWest?
B Blue Cross and Blue Shield of Arizona, Inc. *TriWest Alliance, Inc. is the holding company of TriWest Healthcare Alliance Corp. Blue Cross and Blue Shield of Arizona, Inc., is the largest shareholder of TriWest Alliance, Inc.
What are the 3 types of TRICARE?
This fact sheet provides an overview of TRICARE health plans, including TRICARE Prime, TRICARE Select, TRICARE For Life, and TRICARE Plus.
Is TRICARE West a PPO or HMO?
Is TRICARE a HMO or PPO? Both. TRICARE has HMO (managed care) plan options (the various Prime plans, as well as US Family Health Plan) and PPO options (Select, Select Overseas, Reserve Select, and Retired Reserve).
Who is taking over TRICARE?
If you live in one of these states, or a state that's currently in the West Region, your regional contractor will switch to TriWest Healthcare Alliance on Jan. 1, 2025. This means you should: Take any TRICARE Open Season actions through TriWest by Dec.
Is TriWest a Medicare plan?
Is TriWest a Medicare plan? TriWest pays the Centers for Medicare and Medicaid Services prices for all DME through the Community Care Network (CCN). CCN only covers DME for urgent and emergency care.
How do I verify my TriWest coverage?
Verify the card bearer's TRICARE eligibility online at www.tricare-west.com or by calling the Health Net Federal Services, LLC (HNFS) interactive voice response (IVR) system at 1-844-866-WEST (1-844-866-9378).
Does TriWest need a referral?
This means TRICARE-authorized specialty care providers don't need to wait for TriWest to approve referrals issued by your primary care manager before providing outpatient care. However, you'll still need to get a referral from your Primary Care Manager before getting that specialty care.
Why are doctors dropping TRICARE?
The problem stems from the fact that most Tricare managed care support contractors have negotiated physician reimbursement rates that are even lower than those paid by Medicare. Unhappy with their fees, some major health care provider groups have simply dropped out of the system.
Is TriWest private insurance?
What States Does TriWest Service? TriWest provides coverage for regions 4, 5, and 6 in the United States and territories. Regions 4 and 5 include the following states: Region 4: Texas, New Mexico, Arizona, California, Nevada, Utah, Colorado, Wyoming, Idaho, Montana, Oregon, Washington, and Hawaii.
Which TRICARE is better?
If you're comfortable with a managed care system and don't mind sticking to a network of doctors, then Tricare Prime may be the right choice for you. However, if you prefer the flexibility of being able to see any doctor that accepts Tricare, then Tricare Select may be a better option.
Is there a difference between TRICARE West and TriWest?
TRICARE members receive care at military-operated facilities or through authorized civilian providers. TriWest members receive services at VA-operated hospitals or civilian facilities that have been approved as part of the CCN.
Can you have TRICARE and Blue Cross Blue Shield?
Active duty service members (including activated National Guard and Reserve members) can't use other health insurance as their primary insurance. TRICARE is the primary payer and coordination of benefits with other insurance carriers does not occur.
Can you use two insurances for prescriptions?
Coordination of Benefits on a prescription plan allows a member with more than one prescription drug coverage plan to have their claims processed through both coverage plans. This can help to offset some costs not covered by a member's primary insurance.
What are some disadvantages of TRICARE?
TRICARE plans have specific payment restrictions for certain diagnostic services, utilization limits on visits or consultation and procedures that TRICARE deems not proven effective.
What are the two primary TRICARE programs?
Available TRICARE plans. There are many different TRICARE plans, but TRICARE Prime and TRICARE Select are the two primary options for active-duty service members and their families.
What does TRICARE not cover?
In general, TRICARE excludes services and supplies that aren't medically or psychologically necessary for the diagnosis or treatment of a covered illness (including mental disorder), injury, or for the diagnosis and treatment of pregnancy or well-child care.
Does VA still use TriWest?
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.
Who qualifies for TriWest?
Who TriWest Serves. Patient eligibility for VA CCN and enrolled TRICARE is different. TRICARE – Enrolled active duty service members, active duty family members, National Guard and Reserve members and their family members, military retirees and their family members, survivors, and certain former spouses.
Who pays first TriWest or Medicare?
If you're on active duty and have Medicare, TRICARE pays first for Medicare-covered services or items, and Medicare pays second. If you aren't on active duty, Medicare pays first for Medicare-covered services, and TRICARE may pay second.