To ensure beneficiaries who use the Department of Defense (DoD) Military Health System receive medically necessary care when they need it, DoD leadership developed access standards for TRICARE Prime enrollees. What’s important is ensuring that access to care is easy, fast and logical. TRICARE’s standards for access are easy:
Other TRICARE Access standards include:
- Wait time while in the waiting room no more than 30 minutes
- Travel time from home to TRICARE Prime enrollment site 30 minutes or less
- Travel time from home to specialty care no more than an hour
Emergency services are available and accessible within the TRICARE Prime service area 24 hours a day, seven days a week. In an emergency, TRICARE beneficiaries should call 911 or go to the nearest emergency room. For urgent or acute care listed above while traveling away from home requires the authorization of a primary care manager. If care is received during off-duty hours, please follow up with your PCMH the next available business day.
Access standards give DoD healthcare leaders a tool to measure the actual waiting and drive times beneficiaries experience and to fix problems when they occur. By measuring access to care, DoD leaders can improve customer service. Their goal is to provide beneficiaries the world’s best access to health care and ensure they receive evaluation of illness in a timely manner.
Besides making access to care easy to track and improve, DoD leaders also realize those long waits at the provider’s office squander away valuable time. That’s why the standards for access also measure how fast beneficiaries receive care for nonemergency situations at the provider’s office. TRICARE’s goal of beneficiaries being treated within 30 minutes of their arrival at the provider’s office is very ambitious compared with other health plans.
Another practical feature of TRICARE is the TRICARE Mail Order Pharmacy (TMOP) program. DoD offers this convenient benefit so that TRICARE beneficiaries don’t have to drive to a pharmacy every month to receive drugs for chronic conditions. To use the TMOP, beneficiaries simply call Express Scripts at 1-866-363-8667 to determine eligibility and obtain mail order envelopes with order forms. For a nominal co-payment, beneficiaries may obtain up to a 90-day supply of drugs. That’s the kind of convenient access to care TRICARE leaders like to promote. For additional information on this convenient benefit go to: http://tricare.mil/mybenefit/home/Prescriptions/FillingPrescriptions/TMOP.
TRICARE offers a very powerful internet resource that can link you to healthcare services and resources called TRICARE Online (TOL). TOL provides a wealth of information and functionality including the ability to:
Schedule appointments at any time online
Submit pharmacy refill requests and check their status
Check on a prescription status or access the
View MTF directions, maps, contact information and clinic hours
View information about TRICARE Programs such as dental and pharmacy services
Access trusted health information
Access benefits information
And much more
Registration for TOL is just a click away at www.tricare.mil.
DiLorenzo TRICARE Health Clinic, Pentagon
Open Monday – Friday, 7 a.m. to 4 p.m.
For more information and to make appointments, call 855-27-6331 or 800-433-3574.
Open Monday – Friday, 7 a.m. to 3:30 p.m.
Walk-in sick call hours are from 7 to 9 a.m. and from 12:30 to 1:30 p.m.
For more information and to make appointments, call 703-692-8700.
For emergencies during non-duty hours, go to:
Walter Reed National Military Medical Center, Bethesda, Md. 20889-5600
Malcolm Grow Medical Center, Andrews Air Force Base, Maryland
Fort Belvoir Community Hospital Emergency room, Fort Belvoir, Virginia
In a life-threatening situation, report to the nearest emergency room.