Point-of-Service Option

With the point-of-service option, you:

• Can visit any TRICARE-authorized provider
• Get routine care
• Don’t need a referral
• Pay more out of pocket

The point-of-service option doesn’t apply if you:

• Are an active duty service member
• Use a plan other than a TRICARE Prime option
• Have a referral. (If you have a referral or authorization, your costs are the same as network costs.)
• Have a newborn or adopted child (until enrolled in TRICARE Prime)
  • Note: Children are covered by TRICARE Prime for 90 days (120 days overseas) after birth or adoption as long as one other family member is enrolled. The point-of-service option won’t apply to children during this time or until the date the contractor receives the enrollment form.
• Have other health insurance
• Get the following types of care:
  • Emergency care 
  • Preventive care from a network provider in your region. If you visit a network provider in another region without a referral from your primary care manager, you’re using the point-of-service option.
  • In some cases, urgent care

Point-of-Service Fees

When you use the point-of-service option, you’ll pay:

• A $300 deductible ($600 family deductible)
• 50% of the TRICARE allowable charge 
• Any other fees charged by non-network providers

These fees don’t apply to your annual catastrophic cap.