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FAQs

ACUTE APPOINTMENT DEFINITION:

An urgent (acute) care appointment is reserved for non-emergent, urgent care that is typically delivered by an MTF or network primary care manager (PCM). Acute care services for active duty and TRICARE Prime enrollees shall be scheduled no greater than 24 hours from the time the need for this appointment is determined. Exception: Beneficiaries may waive the 24-hour access standard.

ROUTINE APPOINTMENT DEFINITION:

A routine care appointment is designated for patients who require a visit with their PCM for a new healthcare problem that is not considered urgent. Routine care for active duty and TRICARE Prime enrollees shall be scheduled within seven calendar days from the time the need for this appointment is determined. Exception: Beneficiaries may waive the 7-Day access standard.

WELLNESS and PCM APPOINTMENT DEFINITION:

A wellness care appointment is designated for patients who require a visit for a wellness/or preventive health concern or with their PCM for an initial visit. This wellness care for active duty and TRICARE Prime enrollees shall be scheduled within 28 calendar days from the time the need for this appointment is determined. Exception: Beneficiaries may waive the 28-Day access standard.

SPECIALTY APPOINTMENT DEFINITION:

A specialty care appointment is designated for patients who require an initial consult, referral, or initial self-referral. Specialty care for active duty and TRICARE Prime enrollees shall be scheduled within 28 calendar days from the time the need for this appointment is determined. A specialty care appointment also includes procedures designated for patients in need of medical procedures.

 

ESTABLISHED APPOINTMENT DEFINITION:

An established care appointment is designated for patients who require follow-up care. Established care for active duty and TRICAE Prime enrollees shall be scheduled in accordance with the provider designated time frame.

 

ACCESS TO CARE STANDARDS AND DEFINITIONS

 
APPOINTMENT TYPE
ACCESS TO CARE STANDARD
ENHANCED ACCESS TO CARE STANDARD
ACUTE
24 Hours
24 Hours
ROUTINE
7 Days
3 Days
WELLNESS
28 Days
7 Days
PCM
28 Days

SPECIALTY
28 Days
7 Days
ESTABLISHED (Follow-up)
Provider Designated
Provider Designated
 

 

Enhanced Access to Care Standards apply to deploying service members (within 180 days of deployment), Soldiers completing reintegration (RSRP).