TRICARE Plan Coverage During and After a Disaster
TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve Beneficiaries
Beneficiaries should receive their health care in the same way, whether at home or displaced. They can self-refer for care, therefore they can continue to see any TRICARE-authorized or certified provider.
NOTE: Some services may require new or prior authorization from Health Net Federal Services, LLC (HNFS). As the provider, you will need to secure prior authorization for your patient.
TRICARE Prime, TRICARE Prime Remote and TRICARE Prime Remote for Active Duty Family Members Beneficiaries
Beneficiaries should receive all routine care and coordinate specialty and urgent care through their primary care manager (PCM); however, during a disaster when the beneficiary cannot reach his or her PCM, the beneficiary can use the TRICARE Point of Service (POS) option.
The POS option allows beneficiaries to seek non-emergency care from any TRICARE-authorized or certified civilian provider, in or out of network, without a referral from their PCM. Beneficiaries incur higher deductibles and cost-shares when they use the POS option; however, providers can get an authorization for care from HNFS so the beneficiary can avoid POS fees.
Note: The POS option does not apply to active duty service members. They must always obtain an authorization from their PCM and HNFS for civilian care.
During disasters and evacuations, TRICARE may issue a temporary "Waiver of PCM Referrals (WPRs)” on a case-by-case basis. This waiver allows beneficiaries to receive care—other than mental health care—without a referral and without paying the higher costs associated with the POS option. Providers and beneficiaries can find out if a temporary WPR has been issued through HNFS's website or by contacting HNFS.
Emergency care does not require a referral or authorization; however, the beneficiary or a family member should notify the beneficiary's PCM, if available, or the on-call provider within 24 hours or as soon as possible after receiving emergency care to coordinate any additional care needed.
TRICARE For Life
Beneficiaries should receive their health care in the same way whether at home or displaced. They may continue to seek care from any Medicare provider. Claims will automatically be directed to TRICARE for payment. For more information or assistance with TRICARE For Life, contact Wisconsin Physicians Service (WPS) – Military and Veterans Health at 1-866-773-0404.