If the military treatment facility (MTF) near you cannot provide the inpatient care you need, you must ask them for a non availability statement (NAS). The following is a summary of non availability statements:

NAS Overview

An NAS is a certification from a military hospital stating that it cannot provide the care. If you don’t get an NAS before you get inpatient care from a civilian source, TRICARE may not share your costs.

The NAS system is now automated. This means that, instead of paper copies of the NASs being sent in with the TRICARE Standard claim, the MTF enters the NASs electronically into the DEERS computer files.

Advance Authorizations

IMPORTANT NOTE: Even though outpatient NASs are no longer required for outpatient procedures (see the Maternity Care section, earlier in this book, for an exception to this), check with your BCAC/HBA/TSC for details on getting advance authorization to have any procedures done. Providers of care—whether or not they participate in TRICARE Standard—are supposed to get these advance authorizations.

Living Near an MTF

If you live in the ZIP code catchment area around an MTF, the only times you don’t need an NAS for non-emergency inpatient care are as follows:

  • When you have other non-TRICARE Standard major medical care insurance that pays first on the bills for TRICARE Standard-covered care. (There may be exceptions to this policy for outpatient care in your TRICARE region. Check with your BCAC/HBA/TSC or Managed Care Support Contractor (MCSC) on this.)
  • In a true medical emergency. A condition that would lead a "prudent layperson" (someone with average knowledge of health and medicine), to believe that the sudden and unexpected onset of a medical condition or the acute exacerbation of a chronic condition that is threatening to life, limb, or sight, and requires immediate medical treatment or which manifests painful symptoms requiring immediate efforts to alleviate suffering. Medical emergencies include heart attacks, cardiovascular accidents, poisoning, convulsions, kidney stones, and such other acute medical conditions as may be determined to be medical emergencies by the Director, TRICARE Management Activity, or a designee. In the case of a pregnancy, a medical emergency must involve a sudden and unexpected medical complication that puts the mother, the baby, or both, at risk. Pain would not, however, qualify a maternity case as an emergency, nor would incipient birth after the thirty-fourth (34th) week of gestation, unless an otherwise qualifying medical condition is present. Examples of medical emergencies related to pregnancy or delivery are hemorrhage, ruptured membrane with prolapsed cord, placenta previa, abruptio placenta, presence of shock or unconsciousness, suspected heart attack or stroke, or trauma (such as injuries received in an automobile accident).

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Important Things to Remember

Be sure to check with your nearby MTF every time you need inpatient care. Even if they couldn’t provide the care you needed the last time you checked, their staffing levels or capabilities may have changed, and they may now be able to care for you.


Remember: An NAS is valid for a hospital admission that occurs within 30 calendar days after the NAS is issued. It will remain valid from the date of admission until 15 days after discharge for any follow-up treatment that’s directly related to the admission.

For newborn care, in the event that a newborn stays in the hospital continuously after the mother’s discharge, the mother’s NAS will remain valid for the infant in the same hospital for up to 15 days after the mother’s discharge. Beyond this 15-day limit, a claim for non-emergency inpatient care requires a valid NAS in the infant’s name.

Remember: Just because an MTF gives you an NAS does not mean that TRICARE Standard can help you pay for all care that you receive from any provider. TRICARE Standard cost shares only the kinds of care allowed by the TRICARE Standard rules. TRICARE Standard helps pay for care only from the kinds of providers TRICARE Standard recognizes. These providers are listed below.