1. Tricare And Urgent Care Visits
  2. Tricare East Urgent Care Copay
  3. Tricare Prime Urgent Care

Covered Services

Learn more about what we cover -
including health, dental, and pharmacy.

Urgent care is care you need for a non-emergency illness or injury. You need urgent care treatment within 24 hours, and you shouldn't have to travel more than 30 minutes for the care. You typically need urgent care to treat a condition that:

  • Doesn’t threaten life, limb or eyesight.
  • Needs attention before it becomes a serious risk to health.

Examples may include things like a high fever or sprained ankle.

Care

Nurse Advice Line

Specialty Care Outpatient Visit $31 $31 Urgent Care Center Visit $31 $31 Emergency Room Visit $63 $63 Inpatient Admission (Hospitalization) $158/ admission $158/ admission TRICARE Prime Point-of-Service Option When you see a TRICARE-authorized provider other than your primary care manager for any nonemergency services without a referral, you pay. Note: Visit our Copayment and Cost-Share Information page for 2021 costs. View the cost information below for TRICARE Reserve Select (TRS) beneficiaries. The sponsor's enlistment date does not determine costs. TRS members are covered under TRICARE Select. Urgent care copay rates (Care for minor illnesses and injuries) There's no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, you must. Be enrolled in the VA health care system, and Have received care from us within the past 24 months (2 years). Primary and Urgent Care, and Telehealth All plans Richmond: All covered services are in network Hampton Roads: HMO services are out of network. Tricare (Network Provider) Primary and Urgent Care, and Telehealth UnitedHealthcare. Primary and Urgent Care, and Telehealth MAMSI Life & Health MDIPA: Not available in Tidewater. Testing copayment waiver: Retroactive to March 18, 2020, TRICARE will waive copayments/cost-shares for medically necessary COVID-19 diagnostic and antibody testing and related services, and office visits, urgent care or emergency room visits during which tests are ordered or administered.

If it's after hours or you're not sure if you need to see a doctor, call TRICARE's Nurse Advice Line 24/7. Call 1-800-TRICARE (874-2273) — Option 1 to talk to a registered nurse who can:

  • Answer your urgent care questions
  • Give you health care advice
  • Help you find a doctor
  • Schedule next-day appointments at military hospitals and clinics

The Nurse Advice Line is available to all TRICARE beneficiaries in the U.S. except those enrolled in the US Family Health Plan. Beneficiaries who live overseas can call the Nurse Advice Line for health care advice when traveling in the U.S., but must coordinate care with their Overseas Regional Call Center.

TRICARE Prime PlansTRICARE Prime plans include: TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas and TRICARE Young Adult-Prime

Care

If you are a(n)…

To get Urgent Care…

Active Duty Family Member

You don’t need a referral.
You can get urgent care from any TRICARE authorized urgent care center or network provider1

Retiree or Retiree Family Member

Active Duty Service Member Enrolled in TRICARE Prime Remote

Active Duty Service Member Living in a TRICARE Prime Service Area1

You should seek care at a military hospital or clinic when/where available, or contact the Nurse Advice Line for assistance.

1If you are a family member or retiree and seek urgent care from a non-network provider outside of a TRICARE authorized urgent care center, you will have to pay point-of-service option cost-shares.

TRICARE Select and All Other TRICARE Plans

If you are a(n)…

To get Urgent Care…

Active Duty Family Member

You don’t need a referral.
You can get urgent care from any TRICARE authorized urgent care center or provider.3

Retiree or their Family Member

3You will pay network or non-network copayments or cost-shares, depending on the type of provider you see.

US Family Health Plan

If you are a…

To get Urgent Care…

US Family Health Plan Member

Visit your designated provider’s web site for details

Copay

Urgent Care Overseas

If you are…

Seeking care…

To get Urgent Care…

Enrolled in TRICARE plan stateside

Overseas while traveling

You don’t need a referral.

To ensure your urgent care visit is cashless and claimless, you must get prior authorization from the TRICARE overseas contractor. Otherwise, you may have to pay the provider up front and file a claim for reimbursement later.

Enrolled in a TRICARE Overseas plan

Overseas

Stateside while traveling

You don’t need a referral.
You can get urgent care from any TRICARE authorized urgent care center or network provider.4, 5

4If you are enrolled in a TRICARE Prime plan and seek urgent care from a non-network provider outside of a TRICARE authorized urgent care center, you will have to pay point-of-service option cost-shares.

5Active Duty Service Members must follow up with their PCM when they receive care outside of a military hospital or clinic, in accordance with DoD and Service regulations.

This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.

Last Updated 6/18/2020

Find a Doctor

Dental
Prescriptions
Vision
Mental Health Therapeutic Services

Coronavirus (COVID-19) Update:

  • Testing copayment waiver: Retroactive to March 18, 2020, TRICARE will waive copayments/cost-shares for medically necessary COVID-19 diagnostic and antibody testing and related services, and office visits, urgent care or emergency room visits during which tests are ordered or administered. COVID-19 diagnostic and antibody tests must meet Families First Coronavirus Response Act (FFCRA) criteria in order to be eligible for the cost-share and copayment waivers.
  • Telemedicine copayment waiver: TRICARE is waiving copayments and cost-shares for covered audio-only or audio/video telemedicine rendered by network providers on or after May 12, 2020. This waiver applies to covered in-network telehealth services, not just services related to COVID-19. Beneficiaries who seek telehealth from non-network providers are liable for their regular copayment or cost-share. TRICARE Prime beneficiaries who seek care from specialists without an approved referral when required are subject to Point of Service fees.

Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate.

Tricare
Note: Visit our Copayment and Cost-Share Information page to view 2020 costs.
  • TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.
  • TRICARE Young Adult costs are based on the sponsor's status.
  • Transitional Assistance Management Program (TAMP) beneficiaries (service members and their family members) follow the active duty family member copayment/cost-share information, based on the TRICARE plan type.

A beneficiary's cost is determined by the sponsor's initial enlistment or appointment date:

  • Group A: Sponsor's enlistment or appointment date occurred prior to Jan. 1, 2018.
  • Group B: Sponsor's enlistment or appointment date occurred on or after Jan. 1, 2018.

Tricare And Urgent Care Visits

TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)

Tricare west urgent care copay
Active Duty Family MembersRetirees and Their Family Members

Group A: $0

Group B: $0

Group A: $31

Group B: $31

TRICARE Select (not including TRICARE Young Adult)

Tricare East Urgent Care Copay

Active Duty Family MembersRetirees and Their Family Members

Group A:

Network Provider: $22
Non-Network Provider: 20%

Group B:

Network Provider: $21
Non-Network Provider: 20%

Group A:

Network Provider: $30
Non-Network Provider: 25%

Group B:

Network Provider: $42
Non-Network Provider: 25%

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

Tricare Prime Urgent Care

TRSTRR
Network Provider: $21
Non-Network Provider: 20%
Network Provider: $42
Non-Network Provider: 25%

TRICARE Young Adult (TYA)

TYA PrimeTYA Select
Active Duty Family MembersRetiree Family MembersActive Duty Family MembersRetiree Family Members
$0$31Network Provider: $21
Non-Network Provider: 20%
Network Provider: $42
Non-Network Provider: 25%