On Terminal Leave

The sponsor’s enrollment doesn’t change, but the sponsor will remain enrolled in your current plan until you separate or retire. If you’re a family member, you can change your enrollment upon relocation. If you’re the sponsor, you may only change your enrollment site once you’re officially retired.

Do you have any changes in your medical status? You must report it to:

  • The transition manager or command transition point of contact
  • Your TRICARE Prime enrollment site

Your TRICARE Prime enrollment site is based on the type of primary care manager you have: 

  • Military PCM: Your enrollment site is the military hospital or clinic where you’re enrolled. 
  • Civilian PCM: Your enrollment site is the Military Medical Support Office at Defense Health Agency—Great Lakes.

Military Hospitals and Clinics

  • You can get care in any military hospital or clinic.
  • You continue to have the priority for care.

Urgent Care

  • You must have a referral and pre-authorization from your enrollment site.
  • After hours? Contact the MHS Nurse Advice Line at 800-874-2273, option 1.

Routine Care

Routine medical care is only authorized when it’s:

  • Part of your active health care needs
  • Pre-planned and pre-authorized with your enrollment site

Veterans Affairs Facilities

If you live near a VA medical facility, you can get routine and urgent care at that facility.

  • You must have a referral from your PCM.
  • Coordinate with your enrollment site for a single authorization for your entire span of terminal leave.
  • The authorization won't include authorization for any non-VA care.
  • You should request VA pre-authorization before leaving your final duty station to start terminal leave.

Overseas

Are you staying overseas on terminal leave and need urgent care in the overseas civilian network? You must have a referral and pre-authorization from the military hospital or clinic where you’re enrolled or from the TRICARE Overseas Program contractor, International SOS.

If you’re traveling or returning to the U.S. while on terminal leave, contact International SOS for a referral and pre-authorization to a TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS. For help, call your TOP Regional Call Center toll-free from the U.S.:

  • Eurasia-Africa: 877-678-1207
  • Latin America and Canada: 877-451-8659
  • Pacific: 877-678-1208
Looking to book an appointment online at a military hospital or clinic? Visit the Secure Patient Portal for more information.

Last Updated 11/21/2024