TRICARE Prime users no longer need referrals for urgent care

TRICARE Prime users no longer need referrals for urgent care
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TRICARE Prime enrollees will now have an easier time accessing urgent medical care.

As of Jan. 1, most TRICARE Prime users won't need referrals for urgent-care visits - something that was previously required after the first two urgent-care visits each year. Point-of-service charges also will no longer apply for urgent-care claims, the Defense Health Agency announced.

“We wanted our servicemembers' families and others to have easier access to urgent care,” Ken Canestrini, acting director of TRICARE Health Plan, said in a release about the changes. “Beneficiaries can go visit an urgent-care center right away anytime they have a need.”

Active duty servicemembers should still use military hospitals and clinics for their medical care. Those enrolled in TRICARE Prime Remote who don't live near a military hospital or clinic, however, won't need a referral when seeking urgent care.

Those on TRICARE Select or any other TRICARE plan can visit any authorized provider - in- or out-of-network - for urgent care.

“MOAA is encouraged by these changes, which address situational realities our families face regarding urgent medical care,” says Col. Dan Merry, USAF (Ret), MOAA's vice president of Government Relations. “TRICARE remains a service-earned value to our troops and their families, and we will continue to advocate on behalf of those currently serving, retirees, and their families to ensure it remains so.”

Urgent care is for non-emergency illnesses or injuries requiring treatment within 24 hours. Examples, according to the DHA, include a sprain, a rising temperature, or a sore throat.

If you're not sure whether to seek urgent care, you can call the 24/7 Nurse Advice Line at (800) TRICARE (874-2273)-Option 1, according to the release. A registered nurse can answer questions, give advice, and assist with finding a provider or scheduling an appointment.

Urgent care can serve as a good option if you're traveling or your primary doctor is unavailable. TRICARE users can find a nearby facility by using the provider-search tool.

Any TRICARE Overseas Prime users in need of care while on temporary duty or leave status in the U.S. may access urgent care without a referral or an authorization. Active duty troops must follow up with their primary-care manager, though, per DoD and service-specific regulations.

You can learn more about this and other changes to TRICARE here.