Rights and Responsibilities
As a TRICARE beneficiary, you have rights regarding your health care and responsibilities for participating in your health care decisions.
As a patient in the Military Health System, you have the right to:
- Easy-to-understand information about TRICARE
- A choice of health care providers that is sufficient to ensure access to appropriate high-quality health care
- Emergency health care services when and where you need it
- Review information about the diagnosis, treatment and progress of your condition
- Fully participate in all decisions related to your health care or to be represented by family members, conservators or other duly appointed representatives if you are unable to fully participate in treatment decisions.
- Considerate, respectful care from all members of the health care system without discrimination based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information or source of payment.
- Communicate with health care providers in confidence and to have the confidentiality of your health care information protected.
- Review, copy and request amendments to your medical records.
- A fair and efficient process for resolving differences with your health plan, health care providers and the institutions that serve them.
As a patient in the Military Health System, you have the responsibility to:
- Maximize healthy habits, such as exercising, not smoking and maintaining a healthy diet.
- Be involved in health care decisions, which means working with providers in developing and carrying out agreed-upon treatment plans, disclosing relevant information and clearly communicating your wants and needs.
- Be knowledgeable about TRICARE coverage and program options, including covered benefits; limitations; exclusions; rules regarding use of network providers; coverage and referral rules; appropriate processes to secure additional information; and appeals, claims and grievanceYou can file a grievance when:
- You have a complaint about the quality of care you received,
- A provider or facility behaved inappropriately, or
- You have any other non-appealable issue.
The grievance may be against any member of your health care team. This includes your TRICARE doctor, your contractor, or a subcontractor. processes.
- Be respectful of other patients and health care workers.
- Make a good-faith effort to meet financial obligations.
- Follow the claims process and to use the disputed claims process when you have a disagreement concerning your claims.
- Report any wrongdoing or fraud to the appropriate resources or legal authorities.
Last Updated 11/27/2018