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.

The most recent appropriations for the Department of War expired at 11:59 p.m. EST on September 30, 2025. Military personnel will continue in a normal duty status without pay until such time as a continuing resolution or appropriations are passed by Congress and signed into law. Civilian personnel not engaged in excepted activities will be placed in a non-work, non-pay status.
To learn how the lapse in appropriations affects your TRICARE benefit, visit 
tricare.mil/shutdown.

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.
Picture of a doctor using a stethoscope on a patient's chest; "Patients needed on Oct. 17 for a focus group discussion about chronic obstructive pulmonary disease, or COPD."

Share your experiences with COPD care and treatm...

News
Sep. 30, 2025

Have you been diagnosed with chronic obstructive pulmonary disease, or COPD? Your feedback could play a key...
Read More
Service member presses down on another service member's arm while lying on a medical table.

National Guard or Reserve? Learn What To Do if Y...

News
Sep. 25, 2025

Are you a member of the National Guard or Reserve? If so, it’s important to know how TRICARE covers you if you...
Read More
DHA logo and Unlock Your Health logo; Medical professional in scrubs shows man in wheelchair papers on a clipboard.

Learn How TRICARE Can Help You Manage Chronic He...

News
Sep. 23, 2025

Living with a chronic health condition can feel hard. But you don’t have to do it alone. TRICARE offers...
Read More
Woman in a dentist's chair holds a mirror and looks at her teeth.

What To Do in a Dental Emergency

News
Sep. 19, 2025

Dental emergencies can happen anywhere, at any time. Whether you crack a tooth or have severe mouth pain,...
Read More
Young boy smiles and hugs mother

Unlock Your Health: How TRICARE Can Support Your...

News
Sep. 18, 2025

Childhood and teen years can be full of ups and downs. It’s normal for kids to be sad or irritable or to have...
Read More
Dental care provider wearing gloves performs dental procedure on patient in dental chair.

Opioids, Pain Management, and Your Oral Health

News
Sep. 17, 2025

If you’ve had certain dental procedures, like wisdom teeth removal, a root canal, or oral surgery, some...
Read More
Woman wearing dental bib opens her mouth as a dentist uses dental equipment.

The Power of Prevention: Using the TRICARE Denta...

News
Sep. 16, 2025

When it comes to your oral health, a little prevention goes a long way. That’s why the TRICARE Dental Program...
Read More
Unlock Your Health graphic, DHA logo, elderly woman and medical care worker sit together on a couch

Unlock Your Health With TRICARE Home Health Care...

News
Sep. 16, 2025

Is leaving home for care a challenge? TRICARE covers solutions that make it easier to get the care—and...
Read More

Sept. 30, 2025

Share your experiences with COPD care and treatment at Oct. 17 Clinical Practice Guideline patient focus group

Have you been diagnosed with chronic obstructive pulmonary disease, or COPD? Your feedback could play a key role in developing and updating clinical practice guidelines across the military and veteran health care systems.

Sept. 25, 2025

National Guard or Reserve? Learn What To Do if You Need Line of Duty Care

Are you a member of the National Guard or Reserve? If so, it’s important to know how TRICARE covers you if you become sick or are injured while activated for 30 days or less. This article explores how, where, and under what circumstances National Guard and Reserve members can get line of duty care.

Sept. 23, 2025

Learn How TRICARE Can Help You Manage Chronic Health Conditions

Living with a chronic health condition can feel hard. But you don’t have to do it alone. TRICARE offers programs and coverage to help you live better with chronic conditions like asthma, diabetes, heart disease, anxiety, and depression.

Sept. 19, 2025

What To Do in a Dental Emergency

Dental emergencies can happen anywhere, at any time. Whether you crack a tooth or have severe mouth pain, knowing what to do can save your smile and reduce damage.

Sept. 18, 2025

Unlock Your Health: How TRICARE Can Support Your Child’s Mental Health

Childhood and teen years can be full of ups and downs. It’s normal for kids to be sad or irritable or to have trouble paying attention or interacting with others at times. But sometimes, these feelings and behaviors are signs that your child could need mental health care. Learn how TRICARE can support your child’s mental health and find tips and resources for supporting your child’s well-being.

Sept. 17, 2025

Opioids, Pain Management, and Your Oral Health

If you’ve had certain dental procedures, like wisdom teeth removal, a root canal, or oral surgery, some dentists may prescribe an opioid painkiller to help manage your pain. While your comfort is a priority, it’s important to also understand any potential negative side effects posed by opioids and the importance of using opioids responsibly.

Sept. 16, 2025

The Power of Prevention: Using the TRICARE Dental Program Benefit To Save You Money

When it comes to your oral health, a little prevention goes a long way. That’s why the TRICARE Dental Program covers two routine dental cleanings and examinations each year.

Sept. 16, 2025

Unlock Your Health With TRICARE Home Health Care and Pharmacy Home Delivery

Is leaving home for care a challenge? TRICARE covers solutions that make it easier to get the care—and drugs—you may need. Your TRICARE plan may cover certain in-home health services and pharmacy home delivery options. This gives you flexibility and convenience in your care.

Sept. 10, 2025

Explore Available Counseling and Mental Health Services

Are you a service member, family member, or survivor? Your TRICARE benefit covers a variety of mental health services. But did you know there are other counseling services available to you? This article explores what services you can access if you need support.

Sept. 9, 2025

Live in the West Region? Learn if You Need To Take Action on Your Referrals Before Oct. 1

Are you a TRICARE Prime beneficiary living in the West Region? Are you currently using a referral to get specialty care? If you used the West Region referral approval waiver to see a specialist between Jan. 1 and June 30, 2025 and need to continue seeing that specialist, you’ll need to get a new referral to a network specialist before Oct. 1, 2025. If you’re still using a valid referral issued by a previous contractor before Jan. 1, 2025, you also need to get a new referral for any care received starting Oct. 1.