This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.
Written by Lt. j.g. Colleen McCue
Have you ever had difficulty obtaining an appointment within access to care standards? Did you know that TRICARE has access to care standards? Educating yourself about the access to care standards will help you and your family receive care in a timely manner.
First, you will need to understand the different types of care such as: emergency care, urgent (acute) care, routine care, well-patient visits, and referrals for specialty care.
Emergency Care: Emergency care is a serious medical condition when you or another person may be in danger of losing life, limb, sight, or developing a permanent disability.
– Examples: Not breathing or no pulse, severe bleeding, chest pain, or the injured person is unable to independently move.
Urgent (Acute) Care: Urgent care is an illness or injury requiring medical attention with 24 hours, but will not result in further disability or death if not treated immediately.
– Examples: Minor cuts, sprain, earache, rising fever, migraine
— Good news! TRICARE issued an Urgent Care Pilot that lets TRICARE Prime family members get two urgent primary care visits without a referral or prior authorization. Active duty service members in TRICARE Prime Remote also qualify for the Urgent Care Pilot.
Routine Care: Routine care is general health care and includes general office visits. Routine care also includes preventive care to help keep you healthy.
– Examples: Treatment of symptoms, chronic or acute illnesses and disease
Well-Patient Visits: Well-patient visits are visits for health promotion and disease prevention and include such things as immunizations, well-baby check-ups, pap smears, and cancer screenings.
– Examples: Immunizations, pap smears
Specialty Care: Specialty care consists of medical services provided by a physician specialist. Specialty care providers offer treatment that your PCM cannot provide.
– Examples: Cardiology, dermatology, gastroenterology
Now that you understand the different types of care, let’s review access to care standards:
* Travel time from beneficiary’s residence to provider
If your access to care is outside of these standards, place call or email the Coast Guard Health Benefits Advisor.
Telephone: 1-800-9-HBA-HBA (800-942-2422)
Contact your regional contractor for more information: Health Net (North) 1-877-874-2273, Humana (South) 1-800-444-5445, or United health Care (West) 1-877-988-9378.
TWITTER Q&A — ASK YOUR QUESTIONS NOW!
Coast Guard Heath, Safety, and Work-Life Service Center will be hosting a Twitter Q&A session Wed. June 8, 2016 from 12 to 1 pm. This is the period of time that Cmdr. Paul Fawcett, chief of medical administration, will answer all of the questions submitted, but you can ask your questions anytime from now until 1 pm Wed. June 8, 2016.
There are several ways to do this:
1) Use your Twitter or Facebook account to ask a question using #HSWLASK
2) Comment below in this blog from your home computer or mobile device
3) Send an email to firstname.lastname@example.org
We hope to hear from you!