Tricare Urgent Care Benefit May Expand to Active Duty

Doctor and Patient
Doctor and Patient

ANCHORAGE, Alaska -- A new benefit that allows Tricare Prime users two free civilian urgent care visits per year with a referral will likely expand to cover all active-duty patients, a top Tricare official said here last week.

Under the current benefit, which started in late May, military family members and retirees on Tricare Prime, as well as active-duty members on Tricare Prime Remote, can visit any in-network urgent care for free two times per person each fiscal year without any kind of referral.

The benefit is part of a three-year pilot program ordered last year by Congress. But Navy Vice Adm. Raquel Bono, head of the Defense Health Agency, told Military.com during a wide-ranging interview here that they are already looking to see how to expand the benefit beyond the two-visit cap -- and to active-duty users.

"We want to make sure that that's something, a benefit, that even our active duty can take advantage of even if they're not Tricare Prime Remote," she said. "I think that'd be something that we would put into our overall plan.

"I want to see how well this plays out, and you know we're also looking to see 'how do we expand that?' " she said.

Currently, only troops who live far away from a military treatment facility, such as those on recruiting or ROTC duty, can utilize the benefit as part of Tricare Prime Remote. Other service members must use a military treatment facility or go through their medical chain of command to get health services.

Bono's plan instead would allow those troops to be seen off base by a civilian doctor without first going through their unit.

Both the House and Senate approved a measure to make referral-free urgent care visits unlimited for families and retirees under the 2017 National Defense Authorization Act. That legislation has yet to become law. No legislation allowing active-duty use has been proposed.

The Tricare urgent care pilot and changes Bono discussed do not impact Tricare for Life users or beneficiaries who use Tricare Standard or Tricare Reserve Select.

Tricare Prime users who meet their two-visit cap or who want to save their no-referral visits for later can request a referral through their primary care provider or Tricare's Nurse Advice Line at 1-800-874-2273.

-- Amy Bushatz can be reached at amy.bushatz@military.com.

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