Fitness for Duty Review

All specialty care requests are then referred from your regional contractor to your Service Point of Contact (SPOC).  The SPOC will review all requests and determine if your health care requires a fitness-for-duty determination.

  • If the SPOC thinks that your condition may change your fitness-for-duty or that your condition requires a medical board, the SPOC will refer you to the closest military hospital or clinic that has the ability to provide the care and make a duty determination.
  • If the SPOC thinks there is no impact on your fitness-for-duty, the SPOC will refer you to a civilian specialist for the care. As a rule, maternity care will be provided locally. The SPOC will provide an answer to your regional contractor within two working days of the request, or sooner for an urgent problem.
  • Your commander also may request a military medical evaluation at his or her discretion.
  • You may choose to obtain your specialty care in a military hospital or clinic at any time if that is your preference and your commander concurs.  Inform your regional contractor when coordinating your referral.
  • You cannot refer yourself to a military or civilian specialist.  If you seek nonemergency care from other sources without first contacting your PCM, you may be held financially responsible for the entire bill for those health care services.
Referral and Authorization Notice

Health Net Federal Services and Humana Military are honoring authorizations and referrals issued by the previous TRICARE contractors through their 2018 expiration dates. There is no action needed for these already-approved requests. If your referral or authorization expired prior to 1/1/18, your provider can submit updated requests to your new TRICARE contractor.

  • If you are in the West RegionClick to closeAlaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington and Wyoming., visit TRICARE West for more information.
  • If you are in the East RegionClick to closeUnder the new regional contracts, the East Region is a merger of the North and South Regions and includes: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding El Paso area), Vermont, Virginia, West Virginia, and Wisconsin., visit TRICARE East for more information.

Last Updated 1/4/2019