Follow Up Tricare Question

j_twitchell

So looking at the out of pocket expense chart it says emergency room visits have $0 copay, which is awesome having a toddler. But then I also see it says visits not to your PCM need a referral, does that include emergency room visits?

ericandmarie

No. I've heard it's best to call TriCare before you go or right after, but I've gone to the ER and a quick care and (gasp) haven't called and been fine.

meltoine

No. The ER does not need a referral. You need a referral to see specialists in-office aside from your PCM, including your GYN. 

Sibil

meltoine:

No. The ER does not need a referral. You need a referral to see specialists in-office aside from your PCM, including your GYN. 

I was told that gyn was the only thing you can self refer. I've successfully done it for a well woman exam and a colpo, in 2 different tricare regions.

meltoine

I see the NP at the clinic here for well-woman exams, but I needed a referral for the GYN off-base. Maybe it's different because we have no GYNs at our clinic?

Sibil

So, you have to go see your PCM (which can take a month) just to say, hi, I need my annual exam, as I and every other women need every year, can you refer?  And then wait on a referral?  And then be assigned to someone 10 miles from home when the person you've been seeing for 3 years is around the corner?  Then wait for the reassignment?  Then wait 3 months for your neighborhood gyn to get a spot to open up?  Yeah, sounds like a recipe for missing some birth control.

 The first time I heard about the self-refer was my first tricare experience.  I called to schedule my annual at the base hospital, and they told me there were no appointments for dependents that month, nor would they even open up the books for the next month.  They basically just told me I was SOL.  Oh, except that I could self-refer.  So I walked into PP the next week and got everything I needed.  Now, not all PPs accept tricare, but that one did, thankfully, or I would have been out of bcps for a long time.

pesci12

You can self-refer off-base for your annual pap smear and optometry exam (as long as that is exactly what you are being seen for - nothing additional) once every 365 days.