Military Significant Others and Spouse Support - MilitarySOS.com
Page 1 of 2 12 LastLast
Results 1 to 10 of 11

Thread: Question regarding Tricare Prime and Emergeny Rooms

  1. AKA: Jerseyatheart86
    Katiebeth86's Avatar
    Katiebeth86 is offline
    AKA: Jerseyatheart86
    Join Date
    Jun 2012
    Location
    The one & only Jersey
    Posts
    4,827

    #1

    Question regarding Tricare Prime and Emergeny Rooms

    Advertisements
    I have Tricare Prime. My PCM is here on base and two of my specialists are at Tripler. My pain management doctor is a civilian and located in Kailua. Tricare gave me a referral for this doctor. I went to the ER at Castle Medical Center in Kailua in Friday. My pain management doctor is on staff there and he told me to go to the ER due to the extreme pain I was in as well as chest pain. There was no way I would have been able to get to Tripler because of the pain I was in. Tripler is on the other side of the island for me.

    I've gotten several different answers to this question so I figured I would ask here. Do I have to call Tricare on Monday to let them know I went to Castle Medical Center's ER? Do I have to let my PCM know as well. I have a follow up with my pain management doctor on Thursday for my ER visit, to get medication refills and to check to see how I am from the procedure I had done on Thursday. Several people have told me it need to call some say no. Any help is appreciated. Thanks!


  2. Pour a little salt, we were never here
    [his] lobster's Avatar
    [his] lobster is offline
    Pour a little salt, we were never here
    Join Date
    Jun 2012
    Posts
    8,737

    #2
    I would call Tricare to be safe. I always call, and they always (so far, knock on wood) tell me it's fine to do whatever it is I was planning to do, but it's best to just check.

    We don't have a base ER though, so life/limb/sight is the rule, and chest pain generally falls under that. I would think even though you technically have a base ER (from the sounds of your post) that going to the closer one could be approved in those cases.
  3. AKA: Jerseyatheart86
    Katiebeth86's Avatar
    Katiebeth86 is offline
    AKA: Jerseyatheart86
    Join Date
    Jun 2012
    Location
    The one & only Jersey
    Posts
    4,827

    #3
    We have a clinic on base, no emergency services. The only military hospital is in Honolulu and I'm on the Marine Base which is about a 25-45 minute drive depending on traffic. Of course this happened right after the clinic on base closed for the weekend, rush hour traffic on a Friday. My husband took me to castle ER since my pain doc suggested it and it was much closer since I was also having chest pains. Castle's ER had no wait at all, I was triaged and into a room within 10 minutes of arriving! That is amazing to me

    I think I am going to call Tricare on Monday so they are aware of the situation.


  4. Banned
    gunsgirl's Avatar
    gunsgirl is offline
    Banned
    Join Date
    Jul 2007
    Location
    lost
    Posts
    17,275
    #4
    I would call to be safe,,but, when I was on prime I never called for a referral and never had Tricare NOT pay.
  5. Member
    kwickham's Avatar
    kwickham is offline
    Member
    Join Date
    Dec 2008
    Posts
    538
    #5
    I was told by tricare I didn't need to call for an ER visit, just to follow up with my PCM if needed.
  6. MilitarySOS Jewel
    KnittingGuamMama's Avatar
    KnittingGuamMama is offline
    MilitarySOS Jewel
    Join Date
    Jan 2010
    Location
    Kings Bay, GA
    Posts
    6,535

    #6
    We've been to the ER several times and never called but it's always been in a military hospital so I'd call just to be on the safe side.
  7. eas
    Senior Member
    eas's Avatar
    eas is offline
    Senior Member
    Join Date
    Feb 2011
    Location
    Ft Hood, TX
    Posts
    789
    #7
    Ive been to an ER in Michigan while on leave and had emergency surgery while my Tricare is the south region! We called just to make sure but they always say its not a big deal and follow up with your PCM when possible, AND FYI you can ALWAYS go to any ER you want even if you live 5 feet from the base ER . They don't make stipulations because they don't want people feeling constricted for emergencies! Hope everything gets better!
  8. MilitarySOS Jewel
    DakotaCowgirl's Avatar
    DakotaCowgirl is offline
    MilitarySOS Jewel
    Join Date
    Feb 2007
    Location
    Home is where our feet land
    Posts
    12,453
    #8
    If it is military, don't need to call. For cilivilan, we always do. According to the Tricare site, you have 24 hours/next business day and no later then 72 hours.

    See What's Covered - Emergency Care
    "Obstinacy is a fault of temperament. Stubbornness and Intolerance of contradiction result from a special kind of Egotism, which elevates above everything else the pleasure of its own autonomous intellect, to which others must bow.: Carl von Clausewitz
  9. Just your everyday, laidback Aussie Girl
    SandyKay's Avatar
    SandyKay is offline
    Just your everyday, laidback Aussie Girl
    Join Date
    Aug 2007
    Location
    Somewhere out there
    Posts
    32,613

    #9
    ER is covered, we have been to Civil ER's many times before and never called and never had a problem. If it's an emergency situation you are supposed to go to the nearest ER anyway. You can call Tricare and let them know, but it's honestly not that big of a deal


  10. Don't ever settle for less than you deserve.
    LoveMikeyBear's Avatar
    LoveMikeyBear is offline
    Don't ever settle for less than you deserve.
    Join Date
    May 2010
    Location
    Clearwater, FL
    Posts
    25,417
    #10
    When I had prime living in San Diego I always went to off base ER's when there was an emergency. Tri-care always paid never had any issues with Tri-care NOT paying. I will say I took DD to the base hospital in San Diego once when she was really sick. After that one time I refused to ever take her back, and I took her to the closer children's hospital for a second opinion. I didn't ask anyone, call Tri-care, or anything I just took her right over to the Children's Hospital. Tri-care when I had prime covered it in full and I didn't pay a thing. Same thing when I got sick enough to need a hospital. Even though I was "only" about 30 minutes away from the base I went to a civilian hospital that was much closer/I felt like I'd get better care at. Tri-care covered the full amount and I didn't pay a thing out of pocket that time either.

    When I had prime I also when to Urgent care places a few times like when I hurt my arm. I didn't think an ER was necessary for a hurt arm, but it was the weekend and so no calling my primary. So I went to a Urgent Care place that I knew took Tri-care and Tri-care covered that as well. Didn't call to get their okay I just went in, because I needed it looked at sooner than later to make sure I didn't break/fracture anything.. Never followed up with my primary for the hurt arm. DD and I did go to follow ups with our primary the times we ended up going to the ER though.
    Signature removed due to size.
Page 1 of 2 12 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •