Save cash: know emergency, urgent care

  • Published
  • By Shari Lopatin
  • TriWest Healthcare Alliance
When sickness or injury strikes, service members and their families may save money by knowing the difference between emergency and urgent care.

Understanding when something constitutes an emergency, or what to do if you need urgent care after-hours, could help you avoid longer waits and out-of-pocket costs.

Emergency Care
Anything severe enough to reasonably believe life, limb or eyesight could be threatened is an emergency. This includes maternity and psychiatric emergencies. Examples of emergency situations are:

· No pulse
· Inability to breathe
· Spinal cord or back injury
· Severe bleeding
· Chest pains
· Severe eye injuries
· Broken bones
· Car accident

In an emergency, beneficiaries should call 9-1-1 or visit the nearest emergency room. Within 24 hours after the visit, TRICARE Prime patients should call their primary care manager--especially if the visit resulted in an inpatient admission. The primary care manager could be their local military clinic.

Urgent Care
An illness or injury that won't cause further disability or death if not treated immediately, but needs medical attention to keep it from evolving into a greater threat, requires urgent care. Examples of urgent care include:

· Minor lacerations
· Urinary tract infections
· Earaches
· Migraine headaches
· Sprains
· Rising fever

Service members and their families should use urgent care facilities through their military clinics first. If that's not an option, they will need to acquire an authorization to visit a community urgent care from their primary care manager or military clinic. Should they need help after-hours and are not sure who to call, they can contact TriWest Healthcare Alliance at 1-888-TRIWEST (874-9378) for guidance.

Beneficiaries that don't receive an urgent care authorization for a community facility may be billed under TRICARE Prime's point-of-service option. This includes additional cost shares and a deductible.

Service members and their families who are not traveling and are at their residences can find a local urgent care facility that accepts TRICARE through TriWest's online provider directory at
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