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Understanding the difference between Tricare vs Triwest

Difference Between TRICARE vs TriWest

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In today’s post, we review some of the similarities and distinctions between two organizations that play integral roles in providing healthcare to members of the U.S. military community: TRICARE vs. TriWest.

What is TRICARE Insurance?

To fully appreciate the differences between TRICARE vs. TriWest, it can be valuable to take a moment to each organization’s purpose and function. We’ll begin with TRICARE.

TRICARE, which is managed by the Defense Health Agency (DHA), has been the U.S. military’s healthcare program since 1996.

In addition to serving active-duty members of all military branches, TRICARE also covers qualified dependents (family members) of active-duty servicemembers, as well as military retirees. 

TRICRE members can receive healthcare in two ways:

  • From military-operated hospitals and clinics
  • From non-military sources that participate in TRICARE’s civilian network of authorized providers 

TRICARE plans cover many types of services, such as:

  • Primary, urgent, and emergency medical care
  • Virtual healthcare, including services that are provided over the phone or via online videoconferencing platforms
  • Vision and dental care
  • Mental healthcare, including suicide prevention services
  • Pharmacy services
  • Reproductive health
  • Preventive care such as mammograms, colonoscopies, and well-baby and well-woman services
  • Specialty care, which includes services such as applied behavior analysis (ABA) to identify symptoms of autism spectrum disorder (ASD)

What is TriWest?

TriWest is a shortened version of TriWest Healthcare Alliance. When this organization was founded, its initial mission was to help TRICARE members access healthcare. 

Since 2013, the TriWest Healthcare Alliance has supported military veterans. Initially, this was through the Patient Centered Community Care (PC3) program. Today, these services are provided through the Department of Veterans Affairs (VA) Community Care Network (CCN).

Presently, TriWest is one of two contracted third-party administrators for the CCN. In this role, TriWest performs duties such as identifying community-based healthcare providers that meet the VA’s standards and processing claims that are filed by covered veterans.

The Community Care Network is organized into five regions. TriWest is responsible for regions 4 and 5: 

  • Region 4 includes 12 states in the western part of the continental United States, plus Hawaii and three U.S. territories (Northern Mariana Islands, Guam, and American Samoa).
  • Region 5 consists solely of Alaska.

California, which is home to Montare Behavioral Health, is part of Region 4.

In the previous section, we mentioned that TRICARE members can access healthcare via military-operated facilities or civilian sources. Veterans also have two options:

  • First, they can get help at a VA hospital. 
  • If a VA hospital doesn’t provide the services they need – or if the covered veteran is located in an area that isn’t served by a VA hospital – they may receive care from non-military providers that are part of the CCN.

Difference Between TRICARE vs TriWest?

When comparing TRICARE vs. TriWest, one of the most significant differences is who they serve. 

To be covered by TRICARE, you must be in one of the following categories:

  • Active duty servicemembers
  • Qualified dependents of active duty service members – which means spouses or unmarried children under the age of 21 (or up to age 23 if enrolled in college)
  • Retirees – which typically means those who served on active duty for a minimum of 20 years – and their spouses

To be covered by TriWest, you must be a military veteran: 

  • In most cases, this means that you served for at least two consecutive years (or for the full duration of your enlistment period) and that you did not receive a dishonorable discharge. 
  • Members of the Reserves or National Guard may also be eligible if they were called to active duty for a certain period of time.

The other main difference between TRICARE vs. TriWest is who provides the healthcare that members receive:

  • 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.

Does TRICARE or TriWest Cover Mental Health Treatment?

One important similarity between TRICARE vs. TriWest is that both cover mental health treatment

Individuals who are covered by either TRICARE or TriWest may get help for a variety of mental and behavioral health needs, including:

Of course, as is also the case with most other insurance providers, the types of covered mental health services, levels of care, and duration of treatment can vary depending on which TRICARE or TriWest plan a person has. 

Begin Mental Health Treatment Using TRICARE or TriWest Insurance Today

If you would like to use TRICARE or TriWest to pay for mental health treatment in California, Montare Behavioral Health is here to help. 

We offer a full continuum of customized mental health services. These include inpatient, outpatient, and day treatment options. At each of our facilities, and at every level of care, you can expect to receive personalized treatment and comprehensive support from a team of skilled and experienced professionals. 

Our team can also help you navigate the intricacies of your insurance plan. With your permission, we can coordinate directly with TRICARE or TriWest to confirm your coverage and verify that you can access all benefits to which you are entitled. We are happy to take on this responsibility for you, so that you can focus your full attention on getting the help you need or supporting your loved one.

To learn more about our programs and services, to get answers to any insurance-related questions, or to schedule a free assessment, please visit our Contact Us page or call us today.