Emergency Care or Urgent Care?

  • Published
  • 61st Medical Group
An illness or injury may happen at any time but may not require emergency care. Have you ever wondered about the difference between Emergency Care and Urgent Care? Knowing beforehand will not only help you be ready for when a sudden injury or illness arises but will also help you keep your out-of-pocket costs under control.

Urgent Care

Your assigned primary care manager is the best option for any illness or injury that won't immediately cause further disability or death, but still requires professional medical attention. If you are not able to get a timely appointment after consulting your PCM, you may be referred to urgent care. TRICARE Prime enrollees must contact their PCM for a referral to avoid additional point-of-service charges.

Emergency Care

Emergencies are different. When is it an emergency? According to TRICARE, an emergency is a medical condition that someone with an average knowledge of health and medicine believes could threaten life, limb, or eyesight without immediate treatment. In an emergency, call 911 or make your way to the nearest emergency room for treatment.

Contact your PCM after the ER visit so that ongoing care can be coordinated. If the ER visit results in an inpatient admission, the hospital should contact TriWest to get the proper authorization.

Be Prepared!

You can use the TriWest Web site to quickly locate the nearest urgent care center or emergency room before you ever need it. That way, when the need arises, you'll already know where to go. Remember to work with your PCM to get the proper authorization before (urgent care), or after (emergency), getting care to avoid point-of-service costs.

If you have any questions about authorizations or accessing emergency or urgent care, please visit TriWest Healthcare Alliance at www.triwest.com or call 1-888-TRIWEST (874-9378).