See What's Covered

Search the A-Z list for a list of covered services. Your coverage and out-of-pocket costs may vary based on who you are and your health plan option.

Emergency Care

TRICARE covers emergency care to include professional and institutional charges and services and supplies that are ordered or administered in the emergency department. An emergency department is defined as an organized hospital-based facility for the provision of emergency services to patients who present for immediate medical attention. The facility must be available 24 hours a day.

If you have an emergency, call 911 or to the nearest emergency room immediately.

If you are enrolled in TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas or the TRICARE Young Adult-Prime Option, you must contact your primary care manager within 24 hours or the next business day after you receive emergency care.

Medical Emergency

The sudden and unexpected onset of a medical condition or the acute exacerbation of a chronic condition listed that is threatening to life, limb or sight that requires immediate medical treatment or manifests painful symptoms requiring immediate palliative efforts to alleviate suffering.

Maternity Emergency

A sudden unexpected medical complication which puts the mother, or fetus, at risk.

Psychiatric Emergency

When, based on a psychiatric evaluation performed by a physician (or other qualified mental health care professional with hospital admission authority), the patient is at immediate risk of serious harm to self or others as a result of mental disorder and requires immediate continuous skilled observation at the acute level of care.

Prior authorization is not required for emergency department care. However, admissions resulting from a psychiatric emergency should be reported to the regional contractor within 24 hours of admission or the next business day after admission but must be reported within 72 hours of the admission.

Disclaimer:

This A-Z list of topics is not all inclusive. TRICARE covers most inpatient and outpatient care that is medically necessary and considered proven. However, there are special rules or limits on certain types of care, while other types of care are not covered at all.

Last Updated 3/26/2014