Changes to TRICARE affecting urgent care policies

  • Published
  • By Natalie Henderson
  • 82nd Medical Group

SHEPPARD AIR FORCE BASE, Texas – With the 2018 changes in TRICARE and new Wisconsin Physician Service billing system, there are a number of local facilities that are no longer TRICARE-authorized for urgent care.


Sheppard Clinic is actively researching these changes. 


At this time, the only TRICARE authorized urgent care facility for active duty family members and retirees is CommunityMed Family Urgent Care located at 3310 Midwestern Parkway in Wichita Falls, Texas. Their facility can be reached at 940-488-4616.


TRICARE Prime beneficiaries have other choices available, however, if these four facilities are used for urgent care needs without a referral, charges will be billed at the “Point-of-Service” option, which include a deductible of $300 for individuals and $600 for families in addition to 50 percent of the TRICARE allowable charges.  These fees will not apply to catastrophic caps.


These facilities include:


1.    Clinics of North Texas ClinicCare

2.    Kell West Family Practice Urgent Care

3.    United Regional Health System CarePlus

4.    Community Health Care Clinic Today Care


All future claims beginning Nov. 1, 2018, will be the patient’s responsibility and reviewed on a case-by-case basis.


Outstanding claims for services rendered before Nov. 1 from these facilities will be processed with no out-of-pocket costs to active duty Prime beneficiaries. Prime retirees will be charged the $30 cost share.  


If you receive a medical bill for urgent care services between Jan. 1–Oct. 31, 2018, please provide a copy of your billing statement along with a signed release of information form (DD 2870) to the Managed Care office at the Sheppard Clinic. 


For additional information, please call (940) 676-6194.