New Urgent-Care Pilot Program for prime beneficiaries Published May 13, 2016 By Staff Reports 100th Air Refueling Wing Public Affairs RAF MILDENHALL, England -- To increase access to care, the Department of Defense is launching an Urgent-Care Pilot Program for TRICARE Prime beneficiaries. This program allows prime enrollees two visits to a network or TRICARE authorized provider without a referral or prior authorization. The Urgent-Care Pilot Program, scheduled to begin May 23, 2016, covers: - Active-duty family members enrolled in TRICARE Prime or TRICARE Prime Remote - Retirees and their family members who are enrolled in prime within the 50 United States or the District of Columbia - Active duty servicemembers enrolled in TRICARE Prime Remote or stationed overseas but traveling stateside Active-duty service members enrolled in TRICARE Prime are not eligible for this program as their care is managed by their service. This pilot also excludes Uniformed Services Family Health Plan enrollees. TRICARE Overseas Program enrollees can receive an unlimited number of urgent care visits, but only when they are traveling stateside and seeking care. There are no point of service deductibles or cost shares for these two urgent care visits, but network copayments still apply. Once the individual receives urgent care, the primary care manager must be notified within 24 hours, or the first business day after the urgent care visit. Authorization requirements have not changed for follow-up care, specialty care or in-patient care. Those not sure of the type of care they need, or require care outside of standard business hours, they should call the Nurse Advice Line at 1-800-874-2273. If the NAL recommends an urgent care visit, and a referral is submitted, that visit will not count against the two visits allowed under the urgent care pilot. However, if after calling the NAL and the patient receives a referal to a military hospital or clinic but goes elsewhere for care, that visit will count against the two preauthorized visits. For more information, visit the Urgent Care Pilot Program web page.