Emergency Care

Emergency care is medical treatment for conditions that pose an immediate threat to life, limb, or eyesight. TRICARE covers emergency services at any emergency facility regardless of network status, and no prior authorization or referral is ever required for genuine emergencies.

What constitutes a medical emergency: • Severe chest pain or difficulty breathing • Uncontrolled bleeding • Loss of consciousness • Severe allergic reactions (anaphylaxis) • Signs of stroke (sudden numbness, confusion, vision loss) • Poisoning or drug overdose • Severe burns • Major trauma or injuries • Psychiatric emergencies (danger to self or others)

TRICARE emergency care rules: • No prior authorization required • No referral needed (even for TRICARE Prime) • Care covered at any emergency department, military or civilian • Must notify your regional contractor within 24 hours (or next business day) • Point-of-service charges do NOT apply to emergencies

Emergency care costs: • TRICARE Prime: Per-visit copay for ER visits (waived if admitted) • TRICARE Select: Cost-share based on plan and provider type • Active duty: No cost for emergency care

After emergency care: • Notify your PCM and regional contractor promptly • Follow-up care should go through normal TRICARE channels • Transfer to an MTF may be arranged if appropriate • Keep all emergency care documentation

If unsure whether your situation is an emergency, call 911 or go to the nearest emergency room. TRICARE will cover genuine emergencies at any facility.