Entitled to Access Standards

The Care You Need, When and Where You Need It

You don’t need "abracadabra" or "open sesame" to unlock the doors to prompt, quality health care. No need for magic carpets either. When you’re a TRICARE Prime member, access to care in a timely manner and within a reasonable distance from home is guaranteed.

As a TRICARE Prime member, you are guaranteed an appointment within the following access standards:

• For urgent care, you should have an appointment within 24 hours.
• For routine care, you should have an appointment within one week.
• For specialty care or a wellness visit, you should have an appointment within four weeks (28 days).

Once at the appointment, you should be seen within 30 minutes for nonemergency care.

At times, however, you may experience high-demand specialty services where appointments may not be readily available within the TRICARE standards. It is important to contact your provider directly and make your appointment based on your schedule and the provider’s availability.

Additionally, you should have a primary care manager (PCM) whose office is within 30 minutes of your home under normal circumstances, and specialty care should be available within one hour of your home.

If you experience situations where a provider cannot adhere to these standards, contact TriWest Healthcare Alliance at 1-888-TRIWEST.

You can also speak to a Beneficiary Counseling and Assistance Coordinator (BCAC) about customer service issues. To find the nearest BCAC, call your local military treatment facility (MTF) or visit www.tricare.mil/bcac and search the BCAC directory.