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 routine or specialty careSpecialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide. 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 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: 
  • 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 
• Learn more about urgent care.

Your Primary Care Manager