Stetson Hills, Fountain:(719) 471-CARE (2273) Pueblo: (719) 695-CARE (2273)

 

 

TRICARE Patients Colorado Springs Urgent Care

QwikCareMD – Urgent Care and Comfort Care Family Practice Are Now Accepting TRICARE Patients: 

QwikCareMD – Urgent Care proudly accepts Tricare! QwikCareMD – Urgent Center is a cost saving alternative to the hospital emergency room.  Visit QwikCareMD – urgent care center if you need to see a physician when your primary care physician office is closed. We also offer Comfort Care Family Practice if you are looking for a primary care physician.  Emergency departments affiliated with a hospital are most likely TRICARE-authorized providers. Beneficiaries and their families will get the appropriate level of care and save money by having urgent care needs met in urgent care facilities such as QwikCareMD – Urgent Care and Comfort Care Family Practice.

What is Tricare?

Tricare is a government sponsored health insurance system designed for active duty military members, their dependents, and military retirees and their dependents.

Who is eligible for Tricare?

Active Duty Military, Activated Guards and Reservists and members of their families and survivors.

Do I need to enroll in Tricare?

Active Duty and Active Guard and Reserve members are automatically enrolled in Tricare.  Family members are enrolled by their sponsor through DEERS (Defense Enrollment Eligibility Reporting System).

Parents and legal guardians must enroll their newborn child in DEERS as soon as possible after birth. To establish a newborn’s TRICARE eligibility in DEERS, you must:

  1. Submit a certificate of “live birth”, in person, to the nearest military ID card facility. Or, you may mail a copy of the birth certificate and a notarized DD Form 1172, “Application for Uniformed Services Identification and Privilege Card,” signed by the sponsor to the following address: Office of Commissioned Corps Operations, ATTN: Division of Commissioned Corps Officer Support, Suite 100, Plaza Level, 1101 Wootton Parkway, Rockville, MD 20852.
  2. Apply for your child’s Social Security number. Go to the Social Security Administration Web site, http://www.ssa.gov or call 800-772-1213 for an application.
  3. Once you receive your child’s Social Security number, go to your nearest identification (ID) card-issuing facility to update their information in DEERS. Or, you may mail a copy of the “Social Security card and the DD Form 1172 to the address listed above. If the Social Security number is not provided within 90 days of the child’s initial entry into DEERS, Direct Care benefits will be suspended.
Tricare Urgent Care In Colorado Springs

Are there different Tricare Programs?

There are several Tricare Programs available, each with its own rules.

  1. Tricare Prime – Available to Active Duty Service Members, their dependents, Retired service members and their families.
    1. Active Duty Members pay no out-of-pocket expenses
    2. Active Duty Family Members are responsible for Point-of-Service fees, if using the point-of-service option
    3. All other Tricare Prime members will be responsible for:

i.     Annual Enrollment fees

ii.     Network Copayments

iii.     Point of Service Fees

  1. Tricare Standard – TRICARE Standard is the TRICARE option that provides the most flexibility to TRICARE-eligible beneficiaries. It is the fee-for-service option that gives beneficiaries the opportunities to see any TRICARE-authorized provider.  TRICARE Standard is not available to active duty service members.  Disadvantages to Tricare Standard include:
    1. No Primary Care Manager
    2. Patient pays Deductible and Co-payment
    3. Patient pays balance if bill exceeds allowable charge and provider is non-participating (up to 15% additional)
    4. Nonavailability statement may be required for civilian inpatient care for areas surrounding MTFs
    5. Beneficiaries may have to do their own paperwork and file their own claims
    6. Tricare for Life – is a supplement to Medicare available to retirees who are eligible for Medicare.  You do not pay any enrollment fees, but you must pay Medicare Part B monthly premiums. Your Part B premium is based on your income.

TRICARE Plan

Referrals 

Authorizations 

Information

TRICARE For Life

No referrals.
Some services need prior authorization.

Be sure to follow Medicare rules.*

Authorization required sometimes when Medicare-covered services are exhausted and or services are not covered and TRICARE is primary payer.

Be sure to follow Medicare rules.*

For more information, visit www.tricare4u.com
Or call WPS TRICARE For Life at 1-866-773-0404.

For more information on Medicare rules, visit http://www.medicare.gov/Default.asp or call
1-800-MEDICARE.

TRICARE
Standard and
Extra

No referrals.
Some services need prior authorization.

Your provider must request prior authorization from your regional contractor, when needed.

For more information, visit http://www.tricare.mil/tricare
standard/preauthorization.cfm

TRICARE Prime

Referrals needed from your Primary Care Manager for specialty care services. Without a referral you pay higher out-of-pocket costs (point of service option).

Your PCM coordinates the referral through the MTF or regional contractor, who finds a specialty provider for you.

You and the specialty provider receive letters listing the services you are authorized to receive.

Your PCM will request prior authorization from your regional contractor when needed.

For more information, visit your regional contractor website
– North Region, Health Net
– West Region, TriWest
– South Region, Humana

Or call
– North Region, Health Net
1-877-TRICARE
– West Region, TriWest
1-888-874-9378
– South Region, Humana
1-800-444-5445

If you plan requires a referral and you are sick or ill and cannot get into your PCM, you can call the referral line (1-888-874-9378  or  719-524-2273) and they will let you know if your symptoms require an Urgent Care visit.  Then you must notify your PCM that you are coming to QwikCareMD – Urgent Care so that he can issue the referral.  We will see you without the referral in hand since it takes most PCMS a few days to get the actually paperwork back…however during this time your care will not be delayed by us.  It is in your best interest to follow up with your PCM after the visit to make sure they issued the referral.  Without the referral TRICARE will process your claim but with reduced benefits meaning you will owe more than if they had done the referral appropriately. For additional information about TRICARE, Click Here.

If you have any further questions about TRICARE coverage, please feel free to give us a call or just stop in anytime. No appointment necessary.  719-471-CARE (2273) – 5799 Stetson Hills Blvd