How does TRICARE cover emergency room visits and urgent care?

TRICARE covers emergency and urgent care:

Emergency Room Care

What's an Emergency • Life-threatening conditions • Severe injuries • Chest pain • Difficulty breathing • Severe bleeding • Poisoning • Major burns

Coverage • Covered worldwide • No prior authorization needed • Go to nearest ER • TRICARE Prime: $104 copay • TRICARE Select: Cost-shares apply • Active duty families: Lower costs

After Emergency Care • Notify TRICARE within 24 hours • Follow up with PCM (Prime) • Keep all receipts and records

Urgent Care

When to Use Urgent Care • Non-life-threatening conditions • Minor injuries • Illnesses needing quick care • After-hours medical needs

Examples • Sprains and strains • Minor cuts • Fever • Ear infections • Minor burns • Allergic reactions (non-severe)

Cost • TRICARE Prime: $34 copay • TRICARE Select: Cost-shares apply • Often cheaper than ER

Choosing Between ER and Urgent Care

Go to ER for • Life-threatening emergencies • Severe chest pain • Major trauma • Stroke symptoms • Severe allergic reactions

Go to Urgent Care for • Minor injuries • Mild illness • Non-emergency conditions

Military Treatment Facilities • Emergency care available 24/7 • Priority for active duty • Space-available for others

Overseas Emergency Care • Covered worldwide • Go to nearest facility • File claims after care • Keep all documentation

Follow-Up Care • Prime: Coordinate with PCM • Select: See any authorized provider • Emergency authorization doesn't cover follow-up

When in doubt, always seek emergency care. Your health comes first.