TRICARE Prime

TRICARE Prime Overseas

TRICARE Prime Remote

TRICARE Prime Remote Overseas

TRICARE Young Adult-Prime

US Family Health Plan

 If you’re an active duty service member, you must get a referral for all care you don’t get from your primary care manager (PCM).

 All others: yes, for all covered services you don’t get from your primary care manager (PCM).

• You don’t need a referral for preventive services or outpatient mental health care visits as long as you get these services from a TRICARE network provider in your region.  
• You may only get the care on your referral. If you get care that’s not on your referral, you will pay point-of-service fees. For example, you have shoulder pain and need to see an orthopedic specialist. Your PCM submits a referral for care to treat your shoulder pain. At the specialist’s office, you ask the doctor to look at your ankle because you’re also having ankle pain. Since your referral doesn’t include services for ankle pain, you would pay point-of-service fees. 

TRICARE Select

TRICARE Select Overseas

TRICARE Reserve Select

TRICARE Retired Reserve

TRICARE For Life

TRICARE Young Adult-Select

You usually don’t need a referral for primary and specialty careSpecialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide.. You need a referral for Applied Behavioral Analysis.

You need preauthorization for some procedures and treatments. For example, you may see a pain specialist without a referral, but may need preauthorization for certain pain treatments.