Bread Crumbs

New Kind of Emergency Room May Not be TRICARE Authorized

4/15/2013

TRICARE beneficiaries may have noticed new kinds of “Emergency Centers” popping up in their area. It may seem like a tempting health care option but, free-standing emergency rooms (ER) that are not affiliated with a hospital may not be TRICARE-authorized. If a provider, such as a free-standing ER, is not authorized then TRICARE is prohibited from paying it “facility fees.” That can leave a beneficiary stuck with a big bill.

Beneficiaries need to “know before you go.”  Check a free-standing ER’s TRICARE status – before emergency care is needed.

TRICARE defines an emergency department as an organized, hospital-based facility available 24 hours a day providing emergency services to patients who need immediate medical attention. Emergency departments affiliated with a hospital are most likely TRICARE-authorized providers. Beneficiaries who seek care at a free-standing ER need to ask if the facility is affiliated with a hospital-based emergency department. If it isn’t, the beneficiary will need to make a decision about getting care elsewhere or being responsible for the facility charges.

Beneficiaries can check if a provider is TRICARE-authorized by calling their regional contractor. Contact information for regional contractors is available at www.tricare.mil/contactus.  All TRICARE network providers are also searchable at www.tricare.mil/findaprovider.  Learn more about emergency care under TRICARE at www.tricare.mil/emergency.

Last Updated 7/9/2014