Health Matters (East) Newsletter

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This quarterly newsletter provides information about your TRICARE benefit. This stateside edition contains information specific to beneficiaries living in the East Region. Learn how to find your region.

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Issue 1 | 2026

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  • Patient advocates, Beneficiary Counseling and Assistance Coordinators, and Debt Collection Assistance Officers: Resources to help you with your TRICARE benefit
    Have you ever had a question about your TRICARE benefit that left you confused or frustrated? There are resources that can help you with your questions or concerns. To get help, start by contacting the right resource. You can resolve many TRICARE concerns by contacting your regional contractor or the DMDC/DEERS Support Office first.
  • New virtual urgent care option for TRICARE Prime beneficiaries in the US
    Are you enrolled in a TRICARE Prime plan? If you see a primary care manager at a military hospital or clinic, you may now have a new way to get urgent care. The Defense Health Agency has expanded its virtual urgent care options in the U.S. This allows TRICARE Prime enrollees ages 12 and older to schedule virtual urgent care through the Military Health System Nurse Advice Line.
  • TRICARE-allowable charges and balance billing: What you need to know
    You may have heard the terms “allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges.” and “balance billing.” But what do these terms mean when you have TRICARE? Keep reading to learn more about different types of TRICARE-authorized providers and what they’re allowed to charge you.
  • Pharmacy copayments waived for TRICARE Prime Remote enrollees in the US beginning Feb. 28, 2026
    Are you an active duty family member enrolled in TRICARE Prime Remote? Do you live in the U.S.? Effective Feb. 28, 2026, you’ll no longer pay a copaymentA fixed dollar amount you may pay for a covered health care service or drug. when filling covered prescriptions. This copayment wavier applies to both retail network pharmacies and TRICARE Pharmacy Home Delivery.
  • Beware of MHS GENESIS scam sites: Learn how you can protect your health information
    If you get care at a military hospital or clinic, the MHS GENESIS Patient Portal is your main tool for managing your care online. You can use it to send secure messages, check test results, review appointments, and more. Unfortunately, scammers can create fake websites that look like official MHS GENESIS pages. These sites try to trick you into sharing personal or health information.
  • Children turning age 21
    Once a child reaches age 21, their TRICARE benefits end. However, there are some exceptions to the age limit (see below). Turning 21 is also a TRICARE Qualifying Life Event, which opens a 90-day period for you to make eligible enrollment changes. A QLE for one family member means all family members may make enrollment changes (see additional conditions below).
  • Claims at your fingertips
    If you’ve ever felt unsure about how to submit a claims, you aren’t alone — and a few key tips can make the process much easier. In most cases, your provider will file your medical claims for you. You’ll receive an explanation of benefits showing what TRICARE paid. In some instances, you may need to file your own claims.

FAQ image

How do I find an urgent care clinic?

Use the East Region network provider directory.

Be sure to follow the rules of your plan. Visit Urgent Care to learn more. 

Note: If it’s after hours or you aren’t sure if you need to see a doctor, check with the Military Health System Nurse Advice Line. It’s available 24/7 by phone, web chat, and video chat. This option isn’t available to USFHP enrollees.

Who do I contact when I have a billing question?

It depends on what the bill is for. After you visit a doctor, dentist, or pharmacy, you get an explanation of benefits. You get:

An EOB isn’t a bill. It’s an itemized statement that shows how TRICARE paid on your claim and what you owe your provider (if anything). If you get a bill from a provider, check your EOB to see if you owe the provider.

If you still have questions after you review your EOB or you don’t have an EOB for the bill you got, call your TRICARE contractor:

TRICARE Prime and the point-of-service option

Are you enrolled in a TRICARE Prime option? The point-of-service option lets you get nonemergency care from a TRICARE-authorized provider other than your primary care manager without a referral.

When you use the POS option, you’ll pay:

  • A POS deductible ($300 per individual or $600 per family)
  • 50% of the TRICARE-allowable charge after you meet your POS deductible
  • Any other fees charged by non-network providers

These fees don’t apply to your catastrophic cap.

The POS option doesn’t apply to you if you:

  • Are an active duty service member
  • Use a plan other than a TRICARE Prime option
  • Have a referral
  • Have a newborn or adopted child
  • Have other health insurance
  • Receive the following:
    • Emergency care
    • Preventive care from a network provider in your region
    • In some cases, urgent care 

Last Updated 2/19/2026