New Urgent Care Pilot Program for Prime Beneficiaries Published June 1, 2016 By Staff Reports Tricare MOUNTAIN HOME AIR FORCE BASE, IDAHO -- To increase access to care, the Department of Defense is launching an Urgent Care Pilot Program for TRICARE Prime beneficiaries. This program allows Prime enrollees two visits to a network or TRICARE authorized provider without a referral or prior authorization. For a list of all the provider types eligible members can see, visit the TRICARE website here. While TRICARE encourages the use of network providers, members may also see non-network providers as long as they are TRICARE-authorized. Visits to providers who are not one of the provider types listed are not covered under this pilot. The Urgent Care Pilot Program, which launched on 23 May, 2016, is for: • TRICARE Prime Remote categorized Active duty service members (including National Guard or Reserve members activated for more than 30 consecutive days) • Non-active duty service members in TRICARE Prime, TRICARE Prime Remote or TRICARE Young Adult Prime • TRICARE Overseas Program beneficiaries traveling in the U.S. (not limited to two visits) Active Duty Service Members enrolled in TRICARE Prime are not eligible for this program as their care is managed by their branch of service. This pilot also excludes Uniformed Services Family Health Plan enrollees. TRICARE Overseas Program enrollees can receive an unlimited number of urgent care visits, but only when they are traveling stateside and seeking care. There are no Point of Service deductibles or cost shares for these two urgent care visits, but network co-payments still apply. Once you receive urgent care, you must notify your primary care manager about that care within 24 hours or the first business day after the urgent care visit. Authorization requirements have not changed for follow up care, specialty care or inpatient care. When you are not sure of the type of care you need, or require care outside of standard business hours, contact the Nurse Advice Line here. If the advice line recommends an urgent care visit and a referral is submitted, that visit will not count against the two visits allowed under the Urgent Care Pilot. However, if you are enrolled to a military hospital or clinic, and there are appointments available or the facility has an available urgent care clinic; choosing to go to a civilian urgent care clinic will count against your two covered visits per year. For more information, please visit the Urgent Care Pilot Program web page here.