Do I need a referral with TRICARE Prime?

Direct answer: In most cases, yes. TRICARE Prime generally requires a referral from your Primary Care Manager (PCM) before you see a specialist.

Applies to: TRICARE Prime · All regions

Details

Your PCM coordinates your care and issues most specialty referrals. Some services — like well-woman exams, urgent care, and emergency care — do not require a referral. Referral and authorization rules can also vary by region and by the specific service, so confirm before scheduling.

What to do next

Confirm this with your Primary Care Manager or regional contractor before scheduling — rules can vary by region and by service.