Bread Crumbs

All Others Enrolled in a TRICARE Prime Plan

You'll get most care from your primary care manager (PCM). Call your PCM to schedule an appointment.

  • You must have a referral from your PCM for any *urgent, routine or specialty care he or she can't provide.
    • Your PCM works with your regional contractor for the referral and authorization. 
    • Your contractor will try to refer you to a military hospital or clinic first. 
    • If not available, you're referred to a network provider (in your region).
  • You don't need a PCM referral for preventive services or the first eight mental health visits if you see a network provider (in your region). 
  • If you get any of the following types of care without a PCM referral, you're using the point-of-service option and will pay more out-of-pocket: 
    • *Urgent, routine or specialty care from any provider other than your PCM
    • Mental health care from a non-network provider
    • Preventive care from a non-network provider

*The Urgent Care Pilot Program began on May 23, 2016. This pilot allows you to get two urgent care referrals per fiscal yearOctober 1 - September 30 without a referral from your PCM.

Your Primary Care Manager

  • May be a military hospital or clinic or a network provider.
  • If enrolled to a military hospital or clinic, you can book some appointments online.
TRICARE Prime Remote 
  • May or may not have an assigned PCM depending on the network providers in your remote location.
  • If you don't have an assigned PCM, you can use any TRICARE-authiorized proveder as your PCM
TRICARE Prime Overseas
  • You'll have an assigned PCM at a military hospital or clinic
  • You'll get most care from your assigned PCM
  • Call International SOS if you need an appointment with an overseas provider
TRICARE Prime Remote Overseas 
  • Contact your Regional Call Center to schedule all appointments.
  • In Canada, you'll get most care from your PCM at a Canadian Forces Health Facility. For help finding a provider, contact the Canadian Forces Medical Group at 1-613-945-6653.

Types of Care

You'll have different access standards and rules for the type of care you need:

Emergency Care 
Urgent Care
  • Urgent care is care needed for conditions such as a sprain, sore throat or rising temperature. 
  • You can expect to get an urgent care appointment within 24 hours (1 day), even if you are traveling.
Routine Care 
  • Routine (primary) care includes general office visits for the treatment of symptoms, chronic or acute illnesses and diseases and follow-up care for an ongoing medical condition.   
  • You can expect to receive a routine care appointment within 1 week (7 days)  
Specialty Care 
  • You can expect to get a specialty care appointment within 4 weeks (28 days)
Preventive Care 
  • Preventive services are health screenings, tests and examinations.  
  • You'll usually get these during regular office visits 
  • You can expect to get an appointment within 4 weeks (28 days)

Last Updated 1/3/2017