Emergency vs. Urgent Care: Do You Know the Difference?

1/15/2019

You feel lousy and know you need medical care. But you aren’t sure if your symptoms require urgent or emergency care. Sometimes it’s difficult to know what level of care you need. Especially when you’re hurt or sick. Learn the difference between emergency and urgent care, and the rules for your TRICARE plan now. That way, you’ll be able to make informed decisions should the need arise.

What is Emergency Care?

An emergency threatens life, limb, or eyesight. Examples include severe bleeding, spinal cord or back injury, chest pain, broken bones, or difficulty breathing. Other types of emergencies include maternity and psychiatric. If you reasonably think you have an emergency, go to the nearest emergency roomClick to closeThe hospital department that provides emergency services to patients who need immediate medical attention. or call 911. If overseas, call the emergency medical service for your area. You want to get in touch with your primary care manager or regional contractor within 24 hours or the next business day after you receive care.

What is Urgent Care?

Urgent care is care you need within 24 hours for a non-emergency illness or injury that requires treatment. Examples include a rising fever or sprained ankle. You should get urgent care before your condition becomes an emergency. Most TRICARE beneficiaries can visit an urgent care center whenever needed, but you should check the urgent care rules for your plan. When possible, visit a TRICARE network provider or a TRICARE-authorized (network or non-network) urgent care center to avoid additional out-of-pocket costs. If you’re a family member or retiree and get urgent care from a non-network provider outside of a TRICARE-authorized urgent care center, you’ll have to pay point-of-service cost-shares.

You can find TRICARE-authorized urgent care centers by searching your region’s provider directory. Active duty service members enrolled in TRICARE Prime or TRICARE Overseas Program Prime must continue to visit military hospitals and clinics for urgent care. A referral would be required for civilian urgent care. 

Not Sure Where to Go After Hours? Call Military Health System Nurse Advice Line

If you reasonably think you have an emergency, go to the nearest emergency room or call 911. Otherwise, contact the Military Health System (MHS) Nurse Advice Line. You can call, chat online, or video chat with a registered nurse 24/7. The nurse can answer questions and give you medical advice. You can also get help with scheduling an appointment within 24 hours at a military hospital or clinic, if available. In the U.S., call the MHS Nurse Advice Line at 1-800-TRICARE (1-800-874-2273) and choose option 1. For all country-specific numbers, visit the MHS Nurse Advice Line website. The MHS Nurse Advice Line is available to TRICARE beneficiaries living or traveling in the U.S. or a country with an established military hospital or clinic. However, if you have the US Family Health Plan, there’s a different resource for you to use.

Take command of your health in 2019 by learning more about your emergency and urgent care coverage. And how to get care based on your TRICARE plan. Remember costs differ based on who you are and your plan, so visit Health Plan Costs for information.

Last Updated 5/16/2019