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-authorized 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.