The new year brought changes for most TRICARE Prime enrollees who no longer need a referral for urgent care visits and point of service charges no longer apply for urgent care claims.
This change replaces the previous policy, which waived referrals for the first two urgent care visits per year.
The change primarily benefits Family members who are TRICARE beneficiaries. Active duty service members who live near military hospitals and clinics, should continue to receive their care at those facilities.
Only service members enrolled in TRICARE Prime Remote who do not live near a military hospital or clinic do not need a referral when seeking an urgent care visit.
“We wanted our service members’ Families and others to have easier access to urgent care,” said Ken Canestrini, acting director, TRICARE Health Plan within the Defense Health Agency. “Beneficiaries can go visit an urgent care center right away anytime they have a need.”
If you use TRICARE Select or any other TRICARE plan, you may visit any TRICARE-authorized provider, network or non-network, for urgent care.
Urgent care is care you need for a non-emergency illness or injury requiring treatment within 24 hours. Examples of urgent care conditions include a sprain, rising temperature or sore throat.
The condition is not an emergency and doesn’t threaten life, limb or eyesight.
If you’re unsure whether to seek urgent care, call the 24/7 Nurse Advice Line at 1-800-TRICARE (874-2273), option 1.
You’ll speak with a registered nurse who can answer your questions and give advice. The nurse can also assist you with finding a provider and scheduling an appointment.
Urgent care is a great option if you need care after hours, while traveling or if your primary care manager is unavailable. Contact your regional contractor to help you find an appropriate urgent care facility or provider. You may also use the TRICARE provider search tool.
This is your benefit. Learn more about the changes at www.tricare.mil/changes and take command of your health.