Attention TRICARE Beneficiaries: It's Covered! Urgent Care Centers in the Tricare Network

12/13/2019

Joseph Jones (Madigan Army Medical Center)

Attention TRICARE Beneficiaries: It's Covered! Urgent Care Centers in the Tricare Network

MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. -- In order to mitigate unnecessary emergency room visits, and increase and improve access to urgent care needs within 24 hours for its patients and TRICARE beneficiaries, Madigan Army Medical Center is launching a robust effort to raise awareness among eligible TRICARE beneficiaries of their Urgent Care Center (UCC) access.

Patients who use TRICARE Prime, or any other TRICARE plan, may visit any TRICARE-authorized network UCC for urgent care. Active duty personnel are not authorized urgent care clinic visits without a referral.

"Madigan wants to remind our active duty family members, retirees and retiree family members of their TRICARE benefits," said Maj. Gabriella Niess, chief of Madigan's Managed Care Division. "Visits to TRICARE-authorized network Urgent Care Centers no longer require an authorization, allowing beneficiaries improved access to care for non-emergency illness or injury requiring treatment within 24 hours."

A copay of $30 is required for all retirees and retiree family members seen at a TRICARE-authorized network UCC. Active duty family members will not have a copay. If patients have questions related to a UCC visit, they can contact the Madigan Referral Management Center (Monday through Friday, 7:30 a.m. to 4:30 p.m.) at 253-968-1145, and choose option #5 for assistance.

What exactly is urgent care and how does it differ from a medical emergency requiring an emergency room visit? It can be confusing since the words may appear to be interchangeable. A patient may feel sick and know that they need medical care, but may not be certain if the symptoms require a UCC visit or a trip to an emergency room. Sometimes it's difficult to know what level of care is needed especially when you're hurt or sick.

Urgent care is medical attention needed for a non-emergency illness or injury requiring treatment within 24 hours. Examples of urgent care conditions include a sprain, rising temperature or sore throat. In general, it isn't an emergency and doesn't threaten life, limb or eyesight. Madigan's enrolled active duty family members, retirees and retiree family members are authorized to visit a TRICARE-authorized network UCC for care without an appointment or a PCM referral.

A medical emergency on the other hand, is an injury or illness that threatens life, limb or eyesight. Examples include severe bleeding, spinal cord or back injury, chest pain, broken bones or difficulty breathing. Other types of emergencies include maternity/obstetric emergencies and psychiatric crises. If you reasonably think you have an emergency, go to the nearest emergency room or call 911.

Allowing the Emergency Department to focus on patients with medical emergencies and avoid visits that are more suited for a UCC visit, improves wait times for Madigan's ED patients and allows the ED to operate at its full emergency care and trauma response capabilities. Most importantly, patients may also find more convenience and accessibility in visiting a UCC in the local community as well, since no scheduling is required.

If follow-up care is required following a UCC visit however, please call the Puget Sound Military Appointing Center at 1-800-404-4506 (Monday through Friday: 6:00 a.m. to 9:00 p.m., Saturday through Sunday: 7:00 a.m. to 3:30 p.m.) to schedule an appointment with your Primary Care Clinic.

To find a UCC near you, visit www.tricare-west.com and follow the steps below:

Step 1. Upper left Portal, click "BENEFICIARY"

Step 2. Top Menu Bar, click on "COVERED SERVICES - URGENT CARE"

Step 3. Top of the page under step 3, click the on the link for "NETWORK PROVIDER DIRECTORY"

Step 4. Specify "URGENT CARE CENTER" under "SEARCH FOR" and add address

Step 5. Add additional parameters if desired, or else just submit at the bottom and a list will be generated of authorized UCC locations close to your residence

For more information, visit these sites:

For a full list of copay costs information, visit:

https://www.tricare-west.com/content/hnfs/home/tw/prov/ benefits/costs/urgent_care_costs.html

Find a TRICARE-authorized Urgent Care Center near you:

www.tricare-west.com

To get more information on TRICARE-authorized Urgent Care Center access, visit: https://www.mamc.health.mil/patients/tricare-urgent-care.aspx