Question

An individual who chooses to obtain TRICARE-covered nonemergency services outside the TRICARE Prime network of providers without a referral from the primary care manager and without authorization from the health care finder is using the _______ option?

Answer 1

The option that an individual is using if they choose to obtain TRICARE-covered nonemergency services outside the TRICARE Prime network of providers without a referral from the primary care manager and without authorization from the health care finder is the Point of Service (POS) option.

Step-by-step explanation:

The option that an individual is using if they choose to obtain TRICARE-covered nonemergency services outside the TRICARE Prime network of providers without a referral from the primary care manager and without authorization from the health care finder is the Point of Service (POS) option.

The Point of Service (POS) option allows TRICARE beneficiaries to seek care from non-network providers, but it involves higher out-of-pocket costs compared to receiving care from network providers.

For example, with TRICARE Prime, the primary care manager and health care finder help coordinate and authorize care within the network, but with the POS option, beneficiaries can go outside the network without a referral or authorization, but they will have to pay higher deductibles and copayments.