Acute
Appointments are for medical conditions, while
not life or limb threatening, which could become more serious if
not treated. Examples of acute care include eye or ear
infections and suspected bladder infections. The TRICARE access
standard for acute care is 1 day (24 hours).
Routine
appointments, also known as primary care,
include general office visits for the treatment of symptoms,
chronic or acute illnesses and diseases and follow-up care for
an ongoing medical condition. Routine care can also include
preventive care measures to help keep you healthy but normally
stem from specific illness or disease. The TRICARE access
standard for routine care is 1 week (7 days).
Wellness or
preventive care appointments include diagnostic
and other medical procedures not related directly to a specific
illness, injury, definitive set of symptoms or obstetrical care,
but rather performed as periodic health screening, school/sports
physicals or health maintenance. The TRICARE access standard for
wellness care is 4 weeks (28 days).
Specialty
care appointments are provided by a specialist,
such as orthopedics or cardiology, in military or civilian
healthcare facilities after referral by a primary care manager.
The TRICARE access standard for specialty care is 4 weeks (28
days).
Emergency
services are available and accessible 24 hours a
day, seven days a week. In an emergency, TRICARE beneficiaries
should call 911 or go to the nearest emergency room.
TRICARE defines an emergency as a medical, maternity or
psychiatric condition that would lead a "prudent lay person"
(someone with average knowledge of health and medicine) to
believe that a serious medical condition exists, or that the
absence of immediate medical attention would result in a threat
to life, limb or eyesight, or when the person has painful
symptoms requiring immediate attention to relieve suffering.
This includes situations where a person is in severe pain or is
at immediate risk to self or others.
You always have the ability to seek emergency care when
necessary. For all other healthcare requirements, including
acute, routine, wellness, and specialty care, you must have
authorization before receiving those services. Failure to do so
will likely result in you incurring some financial
responsibility. You always have the option to call
1-888-TRIWEST, consult
www.tricareonline.com,
or visit the TRICARE service center at your nearest military
medical treatment facility, to have all your questions answered.
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