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 (ER) 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. Beneficiaries can check if a provider is TRICARE-authorized by calling their regional contractor. Contact information for regional contractors is available at www.tricare.mil/contactus.Â All TRICARE network providers are also searchable at www.tricare.mil/findaprovider.
TRICARE defines an emergency department as an organized, hospital-based facility available 24 hours a day providing emergency services to patients who need immediate medical attention. Emergency departments affiliated with a hospital are most likely TRICARE-authorized providers. Beneficiaries who seek care at a free-standing ER need to ask if the facility is affiliated with a hospital-based emergency department. If it isn’t, the beneficiary will need to make a decision about getting care elsewhere or being responsible for the facility charges.
Learn more about emergency care under TRICARE at www.tricare.mil/emergency.
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