Knowing where to go and what kind of care you need is an important way to ensure you receive the best medical treatment available.
When you need medical care quickly, it can be confusing to figure out where to go. If you get a high fever in the middle of the night, do you head to the nearest emergency room? If you take a fall over the weekend, can the pain and swelling wait until your provider’s office opens, or should you head to an urgent care center for an X-ray?
Knowing where to go and what kind of care you need is an important way to ensure you receive the best medical treatment available.
Learn more about the difference between urgent and emergency care and find out what options are available for Service members and their families.
TRICARE’s Urgent Care and Emergency Care Options
Your rules for getting urgent care are based on your beneficiary category and your TRICARE plan.
TRICARE covers emergency care, including professional and institutional charges and services and supplies that are ordered or administered in an emergency room. If you’re enrolled in a TRICARE Prime plan, contact your primary care manager within 24 hours or the next business day after you get emergency care.
Urgent Care Vs. Emergency Care – Know the Difference
Urgent care is for a
nonemergency illness or injury. According to TRICARE, you typically need urgent care to treat a condition that doesn’t threaten life, limb, or eyesight, but needs attention before it becomes more serious. Urgent care is designed for when you can’t wait for an appointment with your provider, but you don’t need an emergency room. Examples include things like a fever (if a relatively healthy child over 3 months and adults), cold, and flu symptoms, minor burns, minor lacerations that are not actively bleeding heavily, or a sprained ankle. Often, you can get care for minor illnesses or injuries quicker by using urgent care than in an emergency room.
Emergency care is for situations when you need immediate medical attention. Any time you think your life or health is in danger you should seek emergency care, like for the sudden or unexpected onset of a medical condition or the acute exacerbation of a chronic condition that threatens life, limb, or eyesight. Examples of when to seek emergency care right away include trouble breathing, wounds that won’t stop bleeding, stroke symptoms, chest pain, severe allergic reaction symptoms, an unexpected complication during pregnancy (heavy bleeding, severe abdominal pain, or signs of preeclampsia such as sudden severe headache with high blood pressure), severe abdominal pain, signs of sepsis, or signs of a mental health emergency. If you believe you have an emergency, always call 911 (or your international emergency number).
Still Unsure? Reach Out to MHS Nurse Advice Line
If you still aren’t sure
what type of care you need, reach out to TRICARE’s Military Health System (MHS) Nurse Advice Line. The MHS Nurse Advice Line is a resource for TRICARE beneficiaries and their families that allows them to call or chat with a registered nurse 24 hours a day, seven days a week.
A registered nurse can give you evidence-based health care advice, find you an urgent care or emergency care facility, and give you recommendations for the most appropriate level of care. If necessary, you can schedule same-day or next-day appointments, and in some cases, you may be able to get virtual urgent care through the Nurse Advice Line. It can be comforting to ask an expert when it comes to whether or not you should seek urgent care, wait for an appointment with your provider, or head straight to the emergency room.
You can use the Find a Doctor tool to find a TRICARE-authorized (network or non-network) urgent care center or a TRICARE network provider. Urgent care is also available at some military hospitals and clinics. Use Find a Military Hospital or Clinic to find your nearest military facility along with its contact information. Call the facility or check its website to learn if it offers urgent care.
You can also explore your options for getting virtual health services. You can visit the MHS Nurse Advice Line to find out if your concern can be handled virtually. If so, the nurse will schedule a virtual urgent care appointment for the same day or the following day.
Knowing what type of care you need and what your options are based on your particular health care plan are key aspects of ensuring you get the best care possible whenever you need it.