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NEWS | Oct. 8, 2013

Understanding urgent care

By Health Net Federal Services TRICARE

Do you know when to use an urgent care clinic instead of an emergency room?

Health Net Federal Services, LLC, the managed care contractor for the TRICARE North Region, wants to help Service members take charge of their health by providing information that may help in selecting the appropriate health care facility when needed.

Urgent care is needed to prevent an injury or illness from becoming a serious health risk. Examples of urgent care conditions include a sprained ankle, persistent cold and sore throat. 

There are many benefits to using an urgent care clinic, as they are conveniently located and have shorter wait times than emergency rooms. It is appropriate to use an urgent care clinic when your primary care manager (PCM) is not available, such as after hours or on weekends.

Urgent care is not the same as a medical emergency, which threatens life, limb or eyesight. If you or someone you know is experiencing a medical emergency, call 911 or go to the nearest emergency room.

TRICARE Prime, TRICARE Prime Remote and TRICARE Young Adult Prime members need a referral before going to an urgent care clinic. To obtain a referral, beneficiaries should call their PCM or Military Treatment Facility (MTF). If you are unable to reach your PCM or MTF, call Health Net Federal Services at 1-877-TRICARE (1-877-874-2273).

When TRICARE Prime, TRICARE Prime Remote and TRICARE Young Adult Prime members use an urgent care clinic without a referral, they are choosing the Point of Service option, which has higher out-of-pocket costs. The Point of Service option does not apply to active-duty Service members, so they may be responsible for the entire cost of care.

To find an urgent care clinic, beneficiaries should use the Network Provider Directory to locate one near them. Type in the ZIP code, and under specialty, select "Urgent Care Center" or "Convenient Care Clinic." You may also call 1-877-TRICARE (1-877-874-2273) for assistance. 

For more information about urgent care, visit, then click "I'm a Beneficiary," then "Urgent Care" from the "Authorizations" menu.