From a TRICARE Management Activity News Release
The Defense Department will reduce the number of TRICARE Prime service areas in the United States beginning Oct. 1, affecting about 171,000 retirees and their family members.
Those beneficiaries, who mostly reside more than 40 miles from a military clinic or hospital, received a letter earlier this year explaining their options. They will receive a second letter later this month.
TRICARE Management Activity officials said changing the location of Prime service areas has been planned since 2007 as part of the move to the third-generation of managed care support contracts and will allow them to continue their commitment to making high-quality health care available while supporting DOD efforts to control the rising cost of health care for 9.6 million beneficiaries.
TRICARE beneficiaries may have noticed new kinds of “Emergency Centers” popping up in their area. It may seem like a tempting health care option but, free-standing emergency rooms that are not affiliated with a hospital may not be TRICARE-authorized.
If a provider, such as a free-standing ER, is not authorized, then TRICARE is prohibited from paying it “facility fees.” That can leave a beneficiary stuck with a big bill.
Beneficiaries need to “know before you go.” Check a free-standing ER’s TRICARE status – before emergency care is needed.