JOINT BASE ANDREWS, Md. –
When traveling out of the area, TRICARE Prime enrollees are only covered for Urgent or emergency care. Routine care is not authorized when traveling out of the area. Always obtain a referral from your PCM before using a civilian Urgent Care Center or civilian provider or you may be responsible for the costs. Call HNFS at 1 (877) 874-2273 for assistance in locating a provider and then contact your PCM for a referral.
TRICARE beneficiaries are also eligible to call the TRICARE Nurse Advice Line (NAL), to get help making decisions regarding acute health problems. This advice line is available 24 hours a day, 7 days a week and staffed with professional registered nurses who will assist beneficiaries in answering questions and provide help with decisions regarding self-care at home or when it is best to see a healthcare provider. If after speaking with a NAL representative, it is determined that the beneficiary should seek urgent care services, the representative will coordinate the approval on their behalf. If approval is obtained, these urgent care visits will not count towards the initial two visits that do not require an approval.
To access the Nurse Advice Line, dial 1-800-TRICARE (1-800-874-2273) and choose option 1.
Urgent Care Pilot Program
The following beneficiaries can receive two urgent care visits per fiscal year (October 1-September 30) without a referral or authorization under TRICARE's Urgent Care Pilot Program:
active duty service members (ADSMs) enrolled in TRICARE Prime Remote (TPR), including TPR ADSMs stationed overseas when traveling stateside; non-active duty service members enrolled in TRICARE Prime, TRICARE Young Adult Prime or TRICARE Prime Remote for Active Duty Family Members (within the 50 United States or the District of Columbia); and TRICARE Overseas Program enrollees who are traveling and seeking stateside care.
Note: This pilot excludes Uniformed Services Family Health Plan (USFHP) enrollees. TRICARE Overseas Program enrollees can receive an unlimited number of urgent care visits, but only when they are traveling stateside and seeking care.