TRICARE “Access Improvements” May Limit Access – Here’s How You Can Help
Just when we thought TRICARE reform couldn’t get any more disappointing and confusing…another policy detail will leave military families scratching their heads. This time, the letdown comes with potential changes to urgent care access.
Under the current Urgent Care Pilot Program, TRICARE Prime will cover up to two (2) urgent care visits a year without a referral from a primary care provider. The Pilot was a step in the right direction in giving military families access to medical care when they can’t get an appointment at their Military Treatment Facility (MTF) or when traveling.
Under the new policy military families with TRICARE Prime may still be allowed to access urgent care without a referral, however, the actual number of approved urgent care visits for each person will change from year to year. According to the official language – which can be found here – the number of urgent care visits without a referral will vary from “zero to unlimited”; to be determined by the Director of the Defense Health Agency (DHA) each year.
In the FY17 National Defense Authorization Act (NDAA) Congress authorized referral free urgent care without restriction – one of the only definite wins for military families in Congress’ TRICARE reform effort. We’re disappointed the Department of Defense (DoD) chose not to interpret the provision the same way. Instead they chose to impose a limit on the number of referral free urgent care visits; potentially eliminating referral free urgent care altogether.
When military kids are sick, parents want them to be seen by their PCM whenever possible. However, if families can’t get an appointment at their MTF, we believe they should have access to civilian urgent care to avoid unnecessary trips to the ER. The Urgent Care Pilot was a good start, but some families were confused by the limit of two urgent care visits per year. This wasn’t helped by inconsistent communication across the Military Health System. Months after the Urgent Care Pilot started, we spotted the old policy on several Tricare.mil web pages and scrolling across an electronic message board at a military clinic.
If the number of allowed urgent care visits without a referral changes each year, it will surely create even more confusion for military families, in addition to significant communication challenges for TRICARE. Instead of reform, this new urgent care policy takes TRICARE backward. To say we’re disappointed is an understatement.
Between now and November 28, 2017, the DoD will be accepting comments and can be viewed publically after the deadline. We highly encourage you to submit your comments here on how this change will impact your family. We also encourage you to share your comments with us below or on our Facebook Page and we’ll be sure to use your comments when we draft our own written statement.
Whether you submit your comments directly to the DoD or through us, we encourage you to be part of the advocacy process. Your voice matters, because Together We’re Stronger.
Posted November 6, 2017