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NEWS | June 5, 2007

Know the difference between emergency, urgent care

By 437th Medical Group 437th Medical Group

As a TRICARE Prime beneficiary enrolled to the 437th Medical Group, your primary care manager team includes a medical provider, nurse and technician.

This team is your key to gaining the best healthcare services available to you as a TRICARE Prime enrollee. Your PCM team will assist you in getting the right care at the right time.

The bottom line is that we want to take care of you and when appropriate, we want to help you take care of yourself.

Your PCM team provides primary medical care in our medical treatment facility. In the event that you need emergency care or urgent care while local or traveling, your PCM team can refer you for the care you need. Properly obtaining referrals before seeking care outside the MTF will decrease the risk of unexpected bills.

What about emergency care?
In the event of a threat to your life, limb or eyesight, you should proceed to the nearest emergency room. In all emergency situations, you must notify your PCM team within 24 hours or as soon as practical so your PCM team can coordinate any further care needed if they are true emergencies that are covered with the benefits of TRICARE Prime.

What if I'm not sure my illness or injury is an emergency? How is this different from an urgent care condition?
An urgent care condition is serious enough that it might worsen or cause you to suffer unnecessarily if not treated right away. An urgent care condition could be a sprain, sore throat or rising temperature. Urgent care differs from emergency care in that it is not life threatening but can't wait for you to visit your PCM. You must contact your PCM team for instructions before receiving urgent care treatment. Your PCM team may provide guidance, home care advice or a referral to an urgent care clinic.

What if I need emergent or urgent care while traveling?
For emergencies while traveling, you should dial 911 or go directly to the nearest hospital emergency department. Notify your PCM at your home base (or Humana at 1-800-444-5445) within 24 hours or as soon as practical so your PCM team can coordinate any further care needed. For a non-emergency medical condition that can't wait until you return home, coordinate with your PCM team at your home base before seeking care. Your PCM team will need to know where, when and why you are seeking care. You may also call Humana for assistance in coordinating out-of-area care. Properly obtaining referrals before seeking care outside the MTF will eliminate the risk of unexpected bills.

How do I contact my PCM team?
You can always call 963-6880. There is a PCM on call after hours to address your urgent or emergent medical concerns.

It is our privilege to take care of your healthcare needs. Address additional questions to the staff of the 437th Medical Group, Referral Management Center at 963-6901 or 963-6994.