How does TRICARE cover emergency room visits and urgent care?
Quick Answer
TRICARE covers emergency care worldwide without prior authorization. Visit nearest ER for emergencies; urgent care for non-emergencies.
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Detailed Answer
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.
Related TRICARE Terms
Related Questions
What is TRICARE?
TRICARE is the healthcare program for uniformed service members, retirees, and their families worldwide.
What is the difference between TRICARE Prime and TRICARE Select?
TRICARE Prime is a managed care option with a primary care manager and lower costs. TRICARE Select offers more flexibility to choose providers with higher out-of-pocket expenses.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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