Emergency Care

If the beneficiary feels emergency care is needed, he/she should go to the nearest military or civilian emergency room or call 911. An approval from Health Net Federal Services, LLC (HNFS) is not required for this care.

Emergency conditions are those that threaten life, limb or eyesight. Emergency conditions include medical, maternity or psychiatric problems that would lead a layperson to believe a situation exists that without medical help could lead to loss of life, limb or eyesight. An emergency may also include the need for immediate help to treat severe pain or relieve suffering.

Care that does not threaten life, limb or eyesight, but needs attention to prevent it from becoming a serious risk to health is known as urgent care. Visit our urgent care page to learn more.

Note: Care for accidental injury to the teeth alone or emergency room visits for dental pain are not covered by the TRICARE medical benefit.

Emergency Admission

For TRICARE Prime beneficiaries, the facility must notify HNFS of the emergency admission by the next business day following the admission in order to obtain approval from HNFS. All discharge dates must be submitted by the next business day following discharge.

Follow-Up Care

• TRICARE Prime beneficiaries must coordinate all follow-up care with their primary care manager (PCM). If the TRICARE Prime beneficiary is not assigned to a PCM, he or she must coordinate all follow-up care with Health Net Federal Services, LLC (HNFS). Follow-up care that is not coordinated with the PCM or HNFS may be subject to Point of Service cost-shares and deductibles.
• TRICARE Select, TRICARE For Life and beneficiaries with other health insurance do not need to coordinate any follow-up care with HNFS, but should notify their family physician of an emergency room visit.