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Getting Care When on Active Duty

Your status as an active duty service member means you’re covered by TRICARE Prime for claims purposes, but your rules for getting care are slightly different. 

If you are stationed in a remote location for duty and are not close to a military hospital or clinic, you may be enrolled in TRICARE Prime Remote and have slightly different rules for seeing a doctor. Learn more about TRICARE Prime Remote. 

Direct Care

When you’re stationed at a military installation that has a clinic/hospital or troupe clinic, you’re assigned to a Primary Care Manager (PCM) where you are required to get all of your medical care. If you’re assigned to a ship, you’ get care from the medical team on board. Any care that your PCM can’t provide (other than emergency care) requires a referral; this includes urgent care. To schedule appointments: 

  • Call your Military Treatment Facility (MTF) appointment line or use the TRICARE Online (TOL) Patient Portal.  (TOL is only available to those enrolled to an MTF)  
  • If you’re unable to go to your PCM or military hospital or clinic, you’ll need a referral or prior authorization to seek outside care with a network provider. An example may be an emergency or when your military hospital or clinic is closed.
  • If you’re on leave away from your duty station and you need routine or urgent care:
    • You must still have a referral from your PCM. 
    • If after hours, call the Nurse Advice Line at 1-800-TRICARE (874-2273)
      • You must call your PCM the next duty day to inform him/her of care you received

Urgent Care

You should seek urgent care at your military hospital or clinic. If you’re away from home, contact your regional contractor for help obtaining urgent care.

Emergency Care

You may seek care at a network provider during an emergency.

  • Call 911 or go to the nearest emergency room.
  • You may need to pay up front and file a claim for reimbursement.
  • Keep all receipts and file claims in the region where you live, not where you get the care.
  • Call your PCM or military hospital or clinic within 24 hours or the next business day.

 

 

Last Updated 6/1/2018