Getting Care on Terminal Leave
While on terminal leave, you must remain enrolled in your Prime option to ensure you remain fit for discharge until your separation or retirement date. If you have any changes in your medical status, you are required to report it to your transition point personnel and your TRICARE Prime enrollment site, either the military hospital or clinic or if you have a civilian PCM, the Reserve and Service Member Support Office (R&SMSO), Great Lakes. If enrolled in TRICARE Prime Remote, R&SMSO is your point of contact.
Military Hospitals and Clinics
You can get care in any military hospital or clinic regardless of your Service affiliation or enrollment location. You continue to have the first priority for care over all other beneficiary categories.
You must have a referral and authorization from your enrollment site (either a military hospital or clinic or the R&SMSO). Contact the R&SMSO at 1-888-647-6676.
Routine medical care is only authorized as part of your active health care needs and must be pre-planned and pre-authorized collaboratively with your military hospital or clinic or R&SMSO. Contact the R&SMSO at 1-888-647-6676.
Veterans' Affairs (VA) Facilities
If you live near a VA medical facility while on terminal leave, you may get routine or urgent care at that facility. As TRICARE network providers, the VA follows TRICARE rules so a referral and authorization is required. You (the active duty service member) must coordinate with your military hospital or clinic or MMSO (whichever is applicable), who will issue a single pre-authorization to the appropriate regional contractor for you to get routine or urgent outpatient care from the VA facility. The period covered by this preauthorization will be the entire anticipated span of the terminal leave period. The military hospital or clinic or MMSO will send the pre-authorization to the regional contractor before you leave your final duty station to begin terminal leave. The pre-authorization will not include authorization for any non-VA care.
If you are remaining overseas on terminal leave and you need urgent care in the overseas civilian network, you must have a referral and authorization for each episode of care from the military hospital or clinic where you are enrolled or from to from the TRICARE Overseas Program contractor, International SOS.
If traveling or returning to the United States while on terminal leave, you should contact International SOS at 1-877-451-8659 for a referral and authorization to a TRICARE-authorized provider.