Female Patient Being Reassured By Doctor In Hospital Room

TRICARE urgent care changes

Urgent care can be rendered by either a TRICARE network provider or TRICARE-authorized urgent care center

A beneficiary can seek urgent care treatment in one of two ways:

1. Urgent care center:

  • Beneficiaries can receive care at any TRICARE-authorized urgent care center or convenience clinic. Cost shares will apply, as shown in the chart below.
  • TRICARE Prime beneficiaries will not incur point-of-service deductibles and cost shares if the urgent care center or convenience clinic is TRICARE-authorized and either network or non-network.

2. See a TRICARE network provider with a primary specialty designation

  • Must be a network provider that is a specialty that could be a PCM, but does not have to be a PCM
  • Primary care cost shares apply

A TRICARE network provider or TRICARE-authorized urgent care center can render urgent care. Providers must have one of the following primary specialty designations:

  • Family practice
  • Internal medicine; general practice
  • Pediatrician
  • Urgent care center or convenience clinics
  • Obstetricians/Gynecologists (OB/GYN)
  • Physician Assistants (PA)
  • Nurse Practitioners (NP)
  • Certified Nurse Midwives (CNM)

TRICARE Prime cost-shares for Urgent Care Center (UCC) visits

ADFM RETIREE
GROUP A GROUP B GROUP A GROUP B
UCC Visits (CY 2018) $0 $0 $30 $30


TRICARE Select cost-shares for Urgent Care Center (UCC) visits

ADFM RETIREE
GROUP A GROUP B GROUP A GROUP B
UCC Visits (CY 2018), In-Network $21 $20 $28 $40
UCC Visits (CY 2018), Out-of-Network 20% of allowable 20% of allowable 25% of allowable 25% of allowable