What is a non-availability statement in TRICARE?
Quick Answer
A non-availability statement certifies that a military treatment facility cannot provide a needed service, authorizing TRICARE Prime beneficiaries to receive that care from civilian providers.
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Detailed Answer
A non-availability statement (NAS) is a document issued by a military treatment facility (MTF) certifying that a specific healthcare service is not available at that facility, allowing a TRICARE Prime beneficiary to receive the service from a civilian provider at the standard Prime benefit level. NAS requirements apply primarily to TRICARE Prime beneficiaries who live within the catchment area (typically a 40-mile radius) of an MTF. For most outpatient services, NAS requirements have been eliminated, and beneficiaries can seek care from civilian providers through the normal referral process. However, NAS is still required for non-emergency inpatient care for TRICARE Prime beneficiaries residing in an MTF catchment area. The NAS is generated electronically by the MTF and transmitted to the regional contractor. Without an NAS when one is required, the beneficiary may be responsible for point-of-service charges. TRICARE Select beneficiaries do not need non-availability statements as they have direct access to civilian providers.
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Related Questions
What is TRICARE Prime?
TRICARE Prime is a managed care health plan similar to an HMO that provides comprehensive coverage with a primary care manager, low out-of-pocket costs, and referrals for specialty care.
What is a referral in TRICARE?
A referral in TRICARE is an authorization from your primary care manager (PCM) that allows you to see a specialist. Referrals are required under TRICARE Prime but not TRICARE Select.
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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