Skip main navigation

Military Health System

Clear Your Cache

Health.mil has undergone a recent update. For the best user experience we recommend clearing your browser cache.

How To Find Your TRICARE Referrals

Image of How To Find Your TRICARE Referrals. A referral is when your primary care manager sends you to see another provider. If your PCM refers you to a civilian provider, you can find your referral in your TRICARE regional contractor’s online patient portal or by phone.

FALLS CHURCH, Va. – If you have a TRICARE Prime plan, referrals play a big role in how you get health care. A referral is when your primary care manager sends you to see another provider. If your PCM needs to refer you to a civilian provider, your TRICARE regional contractor also plays a role in the referral process.

“When you need a referral to get civilian care, your PCM sends a request to your regional contractor for review,” said Tonya Utterback, referral management expert with the TRICARE Health Plan at the Defense Health Agency. “Once your regional contractor approves the request, you’ll get an electronic authorization letter with instructions for using your referral.”

Read on to learn tips for finding and using your referrals.

Where to find your referral

It typically takes three business days for your contractor to process your referral. To check its status or download your authorization letter, go to your regional contractor’s patient portal. If you don’t already have an account for your region’s portal, you’ll need to create one.

You can also get information about your referral by phone.

What to do with your referral

Your authorization letter will outline the care and number of visits you’re approved for. It will also have information about the provider you’re referred to. Contact that provider to schedule your first appointment. If you want to see a different provider, call your regional contractor.

Don’t forget to check the letter for your referral’s expiration date. Most referrals expire in 180 or 365 days. If your referral expires and you need a new one, contact your PCM.

When you need a referral

Do you need a referral? It depends on your beneficiary category, health plan, and the type of care you need:

  • Active duty service members: You need a referral for any medical care your PCM doesn’t provide. If you get care without a referral, you may have to pay out of pocket.
  • All others with a TRICARE Prime plan: You need a referral for specialty care and some diagnostic services. If you get this care without a referral, you’ll be using the point-of-service option. You’ll pay more out of pocket if you use this option, as outlined in the TRICARE Costs and Fees Fact Sheet.
  • TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve, and TRICARE For Life: You don’t need a referral for most health care services.

To learn more about referrals, check out Referrals and Pre-Authorizations and “Q&A: Getting and Using Referrals With TRICARE.” To learn how to make an appointment with your PCM, go to Book Appointments.

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.

You also may be interested in...

Article
Jan 16, 2025

Unlock Your Health Through the MHS Nurse Advice Line

Unlock Your Health Through the MHS Nurse Advice Line

Do you know what to do when you or a family member feels sick, but it’s outside of business hours or it’s the weekend? TRICARE has a service called the Military Health System Nurse Advice Line that can help when you need healthcare guidance.

Article
Jan 14, 2025

Check Out the Updated TRICARE Publications Suite

Check Out the Updated TRICARE Publications Suite

Are you looking for the latest details about your TRICARE health plan? TRICARE has updated its entire publications suite with information about your health plan. The new publications now include current details like how to find your TRICARE region, how to contact your regional contractor, and what you’ll pay for care.

Article
Jan 8, 2025

DHA Hospitals Earn Top Honors From the Leapfrog Group

DHA Hospitals Earn Top Honors From the Leapfrog Group

The Leapfrog Group has named two Defense Health Agency hospitals among the best in the nation. This shows the military's strong focus on keeping patients safe and providing high-quality care.

Article
Jan 6, 2025

Live in the West Region? Provide Your Payment Information to TriWest Now

Live in the West Region? Provide Your Payment Information to TriWest Now

Do you currently live in the West Region? Or, do you live in one of the six states that moved to the West Region on Jan. 1? If you pay for your TRICARE coverage using a bank electronic funds transfer, credit card, or debit card, you must now securely give your recurring payment information to the West Region contractor, TriWest Healthcare Alliance.

Article
Dec 23, 2024

Preview Four Changes Coming to TRICARE in 2025

Preview Four Changes Coming to TRICARE in 2025

With the end of the year approaching, it’s a good time to consider your family’s healthcare needs for the coming year. As you think about things like scheduling preventive care visits and knowing your 2025 TRICARE costs, you should also note some changes coming to TRICARE in 2025.

Article
Dec 11, 2024

Check the TRICARE Network Provider Directories Ahead of 2025

Check the TRICARE Network Provider Directories Ahead of 2025

If you get care outside of a military hospital or clinic, it’s important to understand your civilian provider options. TRICARE’s new regional contracts, which begin Jan. 1, 2025, will affect the TRICARE provider networks in the U.S. You’re now able to check the network provider directories for both the East Region and West Region.

Article
Dec 3, 2024

Reminder: TRICARE Regions Are Changing Jan. 1, 2025

Reminder: TRICARE Regions Are Changing Jan. 1, 2025

There will be changes to the TRICARE regions in the U.S. on Jan. 1, 2025. While there will still be two TRICARE regions, six states currently in the East Region will move to the West Region. There are also some ZIP codes in four of these states that will be exceptions to the region changes.

Article
Nov 26, 2024

TRICARE Open Season: Understanding Who’s Eligible

TRICARE Open Season: Understanding Who’s Eligible

It’s that time of year again—TRICARE Open Season is here. Open season, which began Nov. 11, runs until Dec. 10. During this period, most beneficiaries with TRICARE Prime or TRICARE Select can make changes to their health plan for coverage starting Jan. 1, 2025.

Article
Nov 20, 2024

TRICARE Now Covers Hearing Aids for Children of Military Retirees

TRICARE Now Covers Hearing Aids for Children of Military Retirees

TRICARE has recently expanded its hearing aid coverage to include eligible children of retired service members. This new coverage results from a new statute. It aims to improve access to life-changing medical technology and help eligible children of retired service members get the hearing aids they need.

Skip subpage navigation
Refine your search
Last Updated: August 11, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery