After hours medical care for TRICARE beneficiaries

  • Published
  • By Capt. Joy Spillers, Group Practice Manager
  • 49th Medical Group
What do you do when you fall and twist your ankle in the middle of the night? Where can you go if your child has a fever? Sometimes not knowing what to do is scarier than the medical problem itself. It is important to know where to go and how to obtain care.

All beneficiaries need to understand the difference between urgent and emergency care so they can receive the appropriate care as quickly as possible.

An urgent healthcare condition is an illness or injury that won't cause further disability or death if not treated within 24 hours, but does require professional intervention to prevent it from developing into a greater health threat.

Some examples of urgent care situations are minor cuts, urinary tract infections, migraine headaches, sprains, rising fevers and possible ear infections.

An emergency is a medical condition that creates a threat for loss of life, limb, eyesight or unrelieved pain.

Some examples of emergency situations are severe bleeding, chest pains, severe difficulty or inability to breathe, severe back injury, eye injuries and fractures.

In an emergency, one should always go directly to the nearest emergency room or call 911. Beneficiaries just have to remember to contact Central Appointments at 575-572-2778 or TriWest within 24 hours to advise the 49th Medical Group that an ER visit has been made.

Holloman's TRICARE Prime and Plus beneficiaries requiring urgent care should call Central Appointments 24 hours a day, seven days a week. During clinic duty hours -- 7 a.m. to 4:30 p.m. -- choose the appropriate option after calling and follow the instructions provided by the appointment clerk.

For active duty members needing urgent care, a telephone consult will be placed to the primary care team and a nurse will return the call with additional instructions as soon as possible. The team will do everything possible to have the patient seen within 24 hours and if they are unable, they will authorize care in the network.

If a patient calls after the clinic closes, they should stay on the line and the call will be answered by clinic personnel. An on-call primary care provider will make contact with the patient and provide additional instructions or grant authorization to seek care in the network.

When beneficiaries are traveling out of the local area and require urgent medical care, they should follow the same instructions as above. The patient should make sure to tell the individual on the phone that they are out of the local area.

When beneficiaries have urgent care medical issues and have been authorized to seek network urgent care, be aware that there are several TRICARE urgent care facilities that may be utilized in the local area. Be sure the proper pre-authorization has been obtained before being seen and understand it is good for one visit. If authorization has not been obtained, the patient may be billed under the TRICARE Prime Point-Of-Service option which requires the sponsor to pay out-of-pocket deductable and co-pay expenses.

For additional information about TRICARE benefits please visit www.triwest.com, call 1-888-TRIWEST (874-9378) or visit the local TRICARE Service Center in the 49th Medical Group Clinic, Building 15.

Local Network Urgent Care Facilities for TRICARE Prime and Plus Beneficiaries:

Alamogordo
Alamogordo Urgent Care
1211 E. 8th Street Suite C
Alamogordo, N.M.
(575) 551-5111

White Sands Missile Range
McAfee U.S. Army Health Clinic
530 Rock Island
White Sands Missile Range, N.M.
(575) 678-1231

Las Cruces
Covenant Clinics
3961 E. Lohman Suite 22
Las Cruces, NM
(575) 556-0200

Concerta Urgent Care
2170 E. Lohman Ave
Las Cruces, NM
(575) 524-888

New Urgent Care
540 Walton Blvd Suite C
Las Cruces, NM
(575) 525-2700