Be Prepared! TRICARE’s Emergency and Urgent Care Procedures

Medical emergencies tend to be sudden, unexpected and stressful for all concerned. They often occur late at night or on weekends or while you’re traveling far from your PCM’s office or military treatment facility (MTF). The time to familiarize yourself with TRICARE’s guidelines for seeking emergency or urgent care is now — before you’re faced with a serious situation.

Emergency

A TRICARE-defined emergency medical condition is characterized by acute symptoms (that can include severe pain) that are serious enough to threaten

• loss of life, limb or eyesight;
• serious impairment of bodily functions or any bodily organ or part;
• serious jeopardy to the health of an individual or the health of a pregnant woman or her unborn child.

Call "911" or go to the nearest emergency room if:

• There is a risk of death or permanent disability
• There is a risk to the life or health of a pregnant woman or her unborn child
• There is a risk of losing use of a limb or other body part
• There is a risk of blindness

Urgent Care

An urgent care condition is defined as one serious enough to worsen or cause unnecessary suffering if treatment is delayed more than 24 hours. Urgent care differs from emergency care in that the condition, though not immediately life or limb-threatening cannot wait for a regular PCM visit. You must contact your PCM or TriWest at 1-888-TRIWEST (1-888-874-9378) for instructions before receiving urgent care treatment.

Seeking Urgent Care When You Need It Has Several Advantages:

• The wait is often shorter than an emergency room.
• Most facilities are open evenings and weekends.
• No appointments are necessary.
• Facilities tend be located in closer to neighborhoods.
• If you go to the ER for a non-emergency, you may end up with a hefty bill to pay.

Local rules, hours and telephone numbers regarding emergency and urgent care and appointments will vary with the individual MTFs. It’s a good idea to know where the closest urgent care facility is, so if you are referred to one by your PCM or TriWest, you will know where to go. Keep your PCM's phone number, the locations of the closest emergency room and urgent care facility, and TriWest's phone number, 1-888-TRIWEST (1-888-874-9378) available in several places to use in case of an emergency or urgent care situation.