An official website of the United States government
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

News | Feb. 23, 2023

Q&A: Getting and Using Referrals With TRICARE

By TRICARE Communications

You’ve likely heard the term “referral” in connection with health care. But what exactly is a referral—and how do you know if you need one? A referral is when your primary care manager (PCM) or primary care provider sends you to another provider or specialist for care.
 
“When you receive a referral for care, your provider has determined the care will benefit your health,” said Tonya Utterback, referral and authorization expert with the TRICARE Health Plan at the Defense Health Agency. “Once your referral is approved, it’s important to use it in a timely manner. For example, if you’re referred to a cardiologist to evaluate a heart problem, diagnosing and treating the problem as soon as possible may result in a better health outcome.”
 
Read on to learn when you need a referral and helpful tips for using them.
 
Q: Do I need a referral?
A: It depends on your beneficiary category, which TRICARE plan you use, and the type of care you need.
 
If you’re an active duty service member (ADSM):
  • You need a referral for any medical care your PCM doesn’t provide. This includes urgent, routine, preventive, and specialty care.
  • If you get care without a referral, you may have to pay out of pocket.
 
If you use a TRICARE Prime plan (including TRICARE Prime Overseas) and you aren’t an ADSM:  
If you use a TRICARE Select plan or TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE For Life, you don’t need a referral for most medical services. However, your child needs a referral for applied behavior analysis.
 
Q: How long does it take to get a referral?
A: Your provider will send a referral request to your regional contractor. It can take approximately three business days to process your referral.
 
Q: Where do I find my referral?
A: Log in to your beneficiary self-service portal on your regional contractor’s website to view or check the status of your referral. (You’ll need to create an account if you don’t have one.) You can also call your regional contractor’s automated phone service.
 
If overseas, you can check your MyCare Overseas mobile app or web-based portal. You can also call your TRICARE Overseas Program Regional Call Center.
 
Q: What should I do when my referral is approved?
A: When your referral is approved, you’ll receive an electronic authorization letter. This letter will be in your beneficiary portal. The letter will outline:
  • The reason for the referral
  • The provider you’ve been referred to
  • The care and number of visits you’re approved to receive
  • The date the referral expires
 
To make your first appointment, contact the provider named in the letter.
 
Contact your regional contractor if any of the following apply to you:
  • You can’t get an appointment within four weeks
  • You want to see a different provider
  • The provider you’re referred to is more than 60 minutes from your home and you want to change your provider
  • Overseas, if you encounter a language barrier when booking an appointment
 
Q: How long does my referral last?
A: Most referrals are valid for up to 180 or 365 days. However, some referrals have different expiration dates. Check your authorization letter to confirm when the referral expires.
 
If you have ongoing specialty care needs, you should request a new referral from your primary care provider before the referral expires. To avoid potential gaps in care, request your referral at least 30 days before your existing referral expires.
 
If your referral expires and you still wish to receive specialty care, you must request a new referral from your doctor.
 
Q: What should I bring to my first appointment with a specialist?
A: Bring your military ID and referral authorization letter to your appointment. When you schedule your appointment, ask about what other materials your specialist needs. For example, you may need to provide copies of medical records, X-rays, or lab results. The specialist may coordinate with your referring provider to get these materials. In this case, you may be asked to sign a release of information. If you need materials from a military hospital or clinic, request them several days in advance of when you’ll pick them up.
 
Q: Can I be reimbursed if I need to travel for specialty care?
A: The Prime Travel Benefit reimburses reasonable travel for a qualified trip by a TRICARE Prime enrollee. Visit Travel Reimbursement for Specialty Care to learn if your trip is eligible and how to use this benefit.
 
Q: How can I find more information?
A: Contact your TRICARE contractor if you have questions about referrals. You can also learn more on their websites:  
Would you like the latest TRICARE news sent to you by email? Visit the TRICARE Subscriptions page today, and create your personalized profile to get benefit updates, news, and more.
Doctor checks a patient's vitals

Unlock Your Health: Learn When To Get Different ...

News
Jul. 01, 2025

When a health issue comes up, knowing where to go for care can make a big difference. Whether it’s an accident...
Read More
Older man and woman smile at each other

Unlock Your Health as You Approach Medicare Elig...

News
Jun. 26, 2025

Are you approaching the age of 65? Unlock your health by signing up for Medicare as soon as you’re eligible...
Read More
Uniformed service member holds thermometer in a patient's mouth.

4 Ways You Can Use Your TRICARE Benefits and Sta...

News
Jun. 24, 2025

What’s on your to-do list this summer? Maybe you’re planning to spend time at the pool, go to a barbecue, or...
Read More
Young girl wrapped in blue and white towel stands on a beach.

Getting Care While You Travel: A TRICARE Guide f...

News
Jun. 17, 2025

Do you have an upcoming trip? TRICARE covers you whether you travel across the country or around the world...
Read More
Man in white shirt reads papers while smiling.

A Quick Guide to Understanding Your TRICARE Dent...

News
Jun. 16, 2025

Understanding your TRICARE Dental Program dental explanation of benefits is important because it helps you...
Read More
Woman in dental chair, gums being examined by dentist wearing pink gloves

The Dentist Is In: Healthy Gums Mean a Healthier...

News
Jun. 13, 2025

Did you know there is a profound connection between gum health and serious medical conditions throughout the...
Read More
Older woman sits at desk looking at monitor with a doctor. TRICARE logo. Text reads, "Patients Needed on June 27 for a Focus Group Discussion about Osteoarthritis. Sign-up deadline is June 26. Learn if you qualify."

Provide Feedback for Clinical Practice Guideline...

News
Jun. 12, 2025

Did you know you can help improve health care for service members, veterans, and their family members? You’re...
Read More
Man in white shirt smiling

Mouth Taping: A New Trend–But What Are Its Effec...

News
Jun. 11, 2025

Mouth taping is the practice of using surgical tape to keep your mouth closed during sleep. It’s recently...
Read More

July 1, 2025

Unlock Your Health: Learn When To Get Different Types of Care

When a health issue comes up, knowing where to go for care can make a big difference. Whether it’s an accident or an illness, TRICARE covers a range of health care services—but the type of care you need determines where you should go.

June 26, 2025

Unlock Your Health as You Approach Medicare Eligibility

Are you approaching the age of 65? Unlock your health by signing up for Medicare as soon as you’re eligible. Medicare Part A and Part B are required to remain eligible for TRICARE, with limited exceptions. Knowing how and when to sign up for Medicare will help you avoid gaps in coverage and late enrollment penalties.

June 24, 2025

4 Ways You Can Use Your TRICARE Benefits and Stay Healthy This Summer

What’s on your to-do list this summer? Maybe you’re planning to spend time at the pool, go to a barbecue, or take a vacation. But don’t take a vacation from your health this summer. Here are four suggested ways you can use your TRICARE benefits this summer.

June 17, 2025

Getting Care While You Travel: A TRICARE Guide for the U.S. and Overseas

Do you have an upcoming trip? TRICARE covers you whether you travel across the country or around the world. Whether you’re heading out for business or taking a family vacation, understanding your coverage options helps you stay prepared for any health issues that might arise.

June 16, 2025

A Quick Guide to Understanding Your TRICARE Dental Program Dental Explanation of Benefits

Understanding your TRICARE Dental Program dental explanation of benefits is important because it helps you track your coverage. This allows you to avoid any unexpected costs.

June 13, 2025

The Dentist Is In: Healthy Gums Mean a Healthier You — What You Should Know

Did you know there is a profound connection between gum health and serious medical conditions throughout the body? From heart disease to diabetes, the state of your gums can significantly impact your long-term health. This article explores the surprising links between oral hygiene and whole-body wellness, offering simple, practical steps you can take today to protect both your smile and your future health.

June 12, 2025

Provide Feedback for Clinical Practice Guidelines in Joint DOD, VA Patient Focus Groups: Osteoarthritis on June 27

Did you know you can help improve health care for service members, veterans, and their family members? You’re invited to join virtual focus groups! The next focus group will discuss osteoarthritis care on June 27 at 2 p.m. ET.

June 11, 2025

Mouth Taping: A New Trend–But What Are Its Effects on Oral Health?

Mouth taping is the practice of using surgical tape to keep your mouth closed during sleep. It’s recently gained popularity as a potential solution for mouth breathing and its related health issues. But is it supported by science or is it just another viral trend?

June 10, 2025

Keep an Eye on Your Vision Health With TRICARE

About 11 million Americans over age 12 need vision correction, according to the CDC. Do you know if you’re one of them? Getting routine eye exams to monitor your eyesight can help detect and prevent eye diseases early.

June 5, 2025

Unlock Your Health: How to Report Fraud and Abuse With TRICARE

Health care fraud and abuse harms everyone. TRICARE is committed to protecting the health information of service members, retirees, and their family members. You can help by knowing how to spot fraud or abuse—and by reporting it when you see it.