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Covered Services

Learn more about what we cover -
including health, dental, and pharmacy.

Urgent Care

Covered by TRICARE?Limits
Yes Your rules for getting urgent care depend on your plan

Urgent care is care you need for a non-emergency illness or injury. You need urgent care treatment within 24 hours, and you shouldn't have to travel more than 30 minutes for the care. You typically need urgent care to treat a condition that: 

  • Doesn’t threaten life, limb or eyesight.
  • Needs attention before it becomes a serious risk to health.

Examples may include things like a high fever or sprained ankle.

Nurse Advice Line

If it's after hours or you're not sure if you need to see a doctor, call TRICARE's Nurse Advice Line 24/7. Call 1-800-TRICARE (874-2273)—Option 1 to talk to a registered nurse who can:

  • Nurse Advice Line Web Ad ImageAnswer your urgent care questions
  • Give you health care advice
  • Help you find a doctor
  • Schedule next-day appointments at military hospitals and clinics

The Nurse Advice Line is available to all TRICARE beneficiaries in the U.S. except those enrolled in the US Family Health Plan. Beneficiaries who live overseas can call the Nurse Advice Line for health care advice when traveling in the U.S., but must coordinate care with their Overseas Regional Call Center.

TRICARE Prime PlansTRICARE Prime plans include: TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas and TRICARE Young Adult-Prime

If you are a(n)…

To get Urgent Care…

Active Duty Family Member

You don’t need a referral.
You can get urgent care from any TRICARE authorized urgent care center or network provider1

Retiree or Retiree Family Member

Active Duty Service Member Enrolled in TRICARE Prime Remote2

1If you are a family member or retiree and seek urgent care from a non-network provider outside of a TRICARE authorized urgent care center, you will have to pay point-of-service option cost shares.

2If you are an active duty service member living in a Prime Service Area, you must seek care at a military hospital or clinic.

TRICARE Select and All Other TRICARE Plans

If you are a(n)…

To get Urgent Care…

Active Duty Family Member

You don’t need a referral.
You can get urgent care from any TRICARE authorized urgent care center or provider.3

Retiree or their Family Member

3You will pay network or non-network copays or cost shares, depending on the type of provider you see.

US Family Health Plan

If you are a…

To get Urgent Care…

US Family Health Plan User

Visit your designated provider’s web site for details

Urgent Care Overseas

If you are…

Seeking care…

To get Urgent Care…

Enrolled in TRICARE plan stateside

Overseas while traveling

You don’t need a referral.

To ensure your urgent care visit is cashless and claimless, you must get prior authorization from the TRICARE overseas contractor. Otherwise, you may have to pay the provider up front and file a claim for reimbursement later.

 

 

Enrolled in a TRICARE Overseas plan

Overseas

Stateside while traveling

You don’t need a referral.
You can get urgent care from any TRICARE authorized urgent care center or network provider.4, 5

4If you are enrolled in a TRICARE Prime plan and seek urgent care from a non-network provider outside of a TRICARE authorized urgent care center, you will have to pay point-of-service option cost shares.

5Active Duty Service Members must follow up with their PCM when they receive care outside of a military hospital or clinic, in accordance with DoD and Service regulations.

Disclaimer:

This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.

Last Updated 2/9/2018

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