5-24-13

TRICARE Prime West Region Referral Waiver Extended

TRICARE Management Activity (TMA) recently announced the continuation of referral waivers for TRICARE Prime beneficiaries in the TRICARE West Region. The waiver period, which was originally slated to end on May 18th, has been extended through June 18, 2013.  The waiver suspends the requirement that all referrals be approved by United Healthcare before the beneficiary could obtain specialty care. United is the new administrator for TRICARE’s West Region and has made progress in reducing the backlog of referral requests since the initial waiver was announced. The extension will allow more time to process existing referrals and ensure beneficiaries are seen by specialists in a timely manner.

The waiver applies to referrals obtained from April 1 through June 18, 2013, for care expected to be received through August 18, 2013. While United Healthcare continues to clear its backlog of referrals, Prime enrollees in the West Region who get a referral from their Primary Care Manager (PCM) will still be able to seek TRICARE-covered services from a network specialist. This authorization waiver is only for TRICARE Prime beneficiaries in the West Region.

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