Tricare Prime Emergency Room Copay



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. 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. TRICARE Prime cost-shares for urgent care center visits: ADFM - Group A/Group B: $0; Retiree - Group A/Group B: $31. Emergency room or civilian hospital to a military or VA hospital; emergency room to a hospital more capable of providing the required level of care; TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult) Active Duty Family Members Retirees and Their Family Members; Group A: Outpatient: $0 Inpatient: $0.

If you feel emergency care is needed, call 911 or go to the nearest military or civilian emergency room. An approval from Health Net Federal Services, LLC (HNFS) is not required for this care.

Tricare

Tricare Prime Emergency Room Copay Cards

Emergency conditions are those that threaten life, limb or eyesight. Emergency conditions include medical, maternity or psychiatric problems that would lead a layperson to believe a situation exists that without medical help could lead to loss of life, limb or eyesight. An emergency may also include the need for immediate help to treat severe pain or relieve suffering.

Tricare Prime Co Pays

Room

Tricare Prime Emergency Room Copay

Care that does not threaten life, limb or eyesight, but needs attention to prevent it from becoming a serious risk to health is known as urgent care. Visit our urgent care page to learn more.

Note: Care for accidental injury to the teeth alone or emergency room visits for dental pain are not covered by the TRICARE medical benefit.

After Emergency Care

Tricare prime emergency room copay

Tricare Prime Retired Emergency Room Copay

  • TRICARE Prime beneficiaries must coordinate all follow-up care with their primary care manager (PCM). If the TRICARE Prime beneficiary is not assigned to a PCM, he or she must coordinate all follow-up care with HNFS. Follow-up care that is not coordinated with the PCM or HNFS may be subject to Point of Service cost-shares and deductibles.
  • TRICARE Select, TRICARE For Life and beneficiaries with other health insurance do not need to coordinate any follow-up care with HNFS, but should notify their family physician of an emergency room visit.