DHA Extends Referral Approval Waiver for TRICARE West Region Prime Beneficiaries

PHOENIX (April 30, 2025) — The Defense Health Agency (DHA) has extended its TRICARE West Region Prime referral approval waiver policy for beneficiaries through June 30, 2025.

The West Region Prime referral approval waiver extension allows Prime beneficiaries to see TRICARE-authorized specialty care providers referred by their primary care manager (PCM) without prior approval.

As the TRICARE West Region administrator, TriWest Healthcare Alliance (TriWest) will not need to approve Prime beneficiaries’ referrals from their PCM to see authorized specialty care providers through the June 30 extension date.

TriWest now also accepts referrals and authorizations from the previous West Region contractor through their expiration or Sept. 30, 2025, whichever occurs first.

This will enable TRICARE West Region beneficiaries to continue receiving specialty services without interruption of their care.

Beneficiaries should continue seeing their PCMs to get referrals for specialty care, even if their PCM isn’t currently in TriWest’s network, DHA says.

However, some military hospitals and clinics have returned to normal referral processing for Prime enrollees. TriWest will need to approve Prime beneficiaries’ specialty care referrals from PCMs located at these facilities.

West Region Prime beneficiaries can read more in this new TRICARE Newsroom article announcing DHA’s referral approval waiver extension.