Traveling with TRICARE Prime

  • Published
  • 82nd Medical Support Squadron
SHEPPARD AIR FORCE BASE, Texas --  As we enter into the holiday season with its associated travel, please review the following information on medical care while traveling.

It is recommended that any routine medical care should be coordinated through your Primary Care Manager before you travel. Beneficiaries receiving routine medical care while traveling without an authorization will be billed as Point of Service and require the beneficiary to pay out of pocket expenses.

Emergency Care - TRICARE defines an emergency as a medical, maternity or psychiatric condition that would lead a prudent layperson to believe a serious medical condition exists or the absence of medical care will result in a threat to life, limb or eyesight (chest pain, inability to breath, head trauma etc.).

If you need Emergency Care, immediately call 911 or report to the nearest emergency room. Provide the ER staff with your ID card. As soon as possible provide your PCM with the name of the facility, contact address/phone number and schedule any follow-up care needed.

Urgent Care - Urgent care services are medically necessary services required for an illness or injury that would not result in further disability or death if not treated immediately (rising fever, lacerations, etc.).

Urgent care requires professional attention and should be treated within 24 hours. Contact Humana at 1-800-444-5445 and ask for the closest urgent or acute care TRICARE-authorized facility. Provide the medical facility with your ID card. You or your family member will need to contact your PCM the next business day to provide the name, contact address/phone number of the facility for an authorization. An authorization must be submitted by your PCM for payment to occur. Remember to schedule up any follow-up care with your PCM.

Filling Prescriptions on the Road - While traveling, you can have your prescriptions filled at a TRICARE network pharmacy. To find a TRICARE retail pharmacy, call 1-866-363-8779 or visit www.express-scripts.com/TRICARE. Beneficiaries should remember to present their ID card when filling their prescriptions.

If you receive a bill for any services received, bring the information into the TRICARE Service Center as soon as possible for clarification and/or authorization for payment. Failure to do so may result in the outstanding medical bills sent to collection for non-payment.