When you have a medical appointment on the calendar, it’s best to prepare ahead of time. It doesn’t take long, and the benefits will help you make the most of your healthcare appointment.
“It’s important to be familiar with what your TRICARE plan covers. You should have all the necessary documents available and be ready with questions for your provider before you go to your appointment,” said Dr. Ross Colt, Medical Director, Clinical Oversight and Integration, TRICARE Health Plan, at the Defense Health Agency. “Whether you’re meeting with a primary care provider or specialist, being prepared can help streamline the check-in process and maximize your time with your provider.”
Depending on where you’re getting care, check out these guidelines so you’re ready for your upcoming appointment.
Your military hospital or clinic will have your electronic health record through your MHS GENESIS Patient Portal. However, every time you see your provider, be sure to:
Did you know that military hospitals and clinics worldwide have a chaperone policy? The policy states that you or your provider can request a trained chaperone to be present in the exam room for any type of exam, including dental exams.
Chaperones are a part of the clinical team—they’re a safeguard for both patients and staff.
If you’re meeting with a civilian doctor, make sure you know if your provider is a TRICARE network or non-network provider. To limit your out-of-pocket costs, verify that your TRICARE plan covers the services you’re receiving.
Double check you’re carrying your Uniformed Services ID card, other health insurance card (if you have OHI), and any required copayment or cost-share.
Additionally, bring a comprehensive list of your:
Your plan determines if you need a referral to see specialist providers. Active duty service members need referrals for any care their primary care manager doesn’t provide. Beneficiaries enrolled in a TRICARE Prime plan need referrals for most care their primary care manager doesn’t provide. In these cases, your PCM will refer you to another provider or a specialist. Those enrolled in all other TRICARE plans only need pre-authorization for certain services.
As described in the Medicare and You Handbook, you’ll need to bring all your health insurance cards with you to your appointment. If you have original Medicare, bring your red, white, and blue Medicare card and your Uniformed Services ID card to your appointment.
If you’re enrolled in a Medicare Advantage plan or have OHI, be sure to bring the plan ID cards, as well as your Uniformed Services ID card.
If any of your insurance coverages have changed, be sure to inform your provider’s office to ensure your claims are processed appropriately.
Keep in mind, there isn’t a TRICARE card to show your provider as proof of eligibility. Learn more about what identification you need to bring with you to your appointment.
And remember to check your information in the Defense Eligibility and Enrollment Reporting System and make any necessary updates. Avoid claims, billings, authorizations, and other issues by keeping your DEERS account current.
Taking some time to prepare for your appointment helps ensure a more meaningful and productive appointment with your provider.