How to Get a TRICARE Referral: 2026 Guide | TRICARE.com

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy and beneficiary records, visit TRICARE.mil.*

## Quick answer To get a referral, you must first visit your Primary Care Manager (PCM), who will evaluate your condition and submit an electronic request to your regional contractor (Humana Military or TriWest). Once approved, you will receive an authorization letter outlining the specific care allowed and the provider you should see.

Details

In the TRICARE system, a **referral** is a request from your PCM for you to see a specialist for a specific medical condition. This is different from an **authorization**, which is the regional contractor's "green light" to pay for that specialty care.

### The Referral Process by Plan Type The requirements for a referral depend entirely on which TRICARE plan you are enrolled in:

* **TRICARE Prime (and Prime Remote):** Referrals are **mandatory** for all specialty care. If you see a specialist without an approved referral from your PCM, you will be charged under the Point-of-Service (POS) option. For 2026, the POS deductible is $300 for individuals and $600 for families, plus 50% of the covered charges. * **TRICARE Select:** Referrals are generally **not required** for most specialty care. You can manage your own specialist visits by finding a TRICARE-authorized provider. However, certain services (like home health or ABA therapy) still require "prior authorization" from your regional contractor even on Select. * **Active Duty Service Members (ADSMs):** You must have a referral for *every* type of care provided outside of a Military Hospital or Clinic. There are no exceptions for ADSMs.

### How to Check Your Referral Status Once your PCM submits the request, it typically takes 2 to 5 business days for the regional contractor to process it. As of 2026, you can check progress through these portals: * **East Region:** Log in to the [Humana Military](https://www.humanamilitary.com/) portal. * **West Region:** Log in to the [TriWest Healthcare Alliance](https://www.triwest.com/) portal.

### Urgent Care and Referrals Most TRICARE beneficiaries (except Active Duty) do not need a referral for urgent care. You can visit any TRICARE-authorized urgent care center without seeing your PCM first. **Active Duty Service Members** still require a referral or prior authorization for all urgent care unless they are seen at a Military Treatment Facility.

### Mental Health Exceptions TRICARE allows "first-look" access for mental health. Most beneficiaries (except Active Duty) can see a TRICARE-authorized mental health provider for outpatient therapy without a referral. Specialized treatments like inpatient stays or residential treatment centers always require prior authorization.

## Who this affects * **Active Duty Service Members:** Always required for any non-emergency civilian care. * **Active Duty Family Members (Prime):** Required for specialty care to avoid high Point-of-Service costs. * **Retirees and their Families (Prime):** Required for specialty care. * **TRICARE Select Users:** Not required for most specialists, though prior authorizations for specific procedures still apply. * **TRICARE For Life (TFL):** Referrals are not required as long as the service is covered by Medicare and TRICARE.

## Sources * **TRICARE.mil:** [Referrals & Authorizations](https://www.tricare.mil/referrals) * **Humana Military (East):** [Manage My Care](https://www.humanamilitary.com/beneficiary/plans-and-benefits/referrals-and-authorizations) * **TriWest Healthcare Alliance (West):** [Understanding Referrals](https://www.triwest.com/en/beneficiary/referrals-authorizations/) * **Defense Health Agency (DHA):** [TRICARE Plans Overview](https://health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/Access-to-Healthcare)