What Is The TRICARE Point of Service (POS) Option? | TRICARE.com

The TRICARE Point-of-Service (POS) option allows TRICARE Prime enrollees to see any TRICARE-authorized provider without a referral. While it offers maximum flexibility to choose your own doctor, it comes with significantly higher out-of-pocket costs, including a deductible and 50% cost-sharing.

*Note: TRICARE.com is an independent reference site and is not an official government agency. For official policy and enrollment, visit TRICARE.mil.*

Details

The Point-of-Service option is a specific feature of **TRICARE Prime** (and TRICARE Prime Remote). It acts as a "safety valve" for beneficiaries who want to see a specialist or a specific doctor outside of the Military Treatment Facility (MTF) or their assigned Primary Care Manager (PCM) network without waiting for an official referral.

### When the POS Option Applies The POS option is automatically triggered when a TRICARE Prime enrollee receives care from a provider other than their PCM without a referral from their PCM and authorization from their regional contractor (Humana Military in the East or TriWest in the West).

### The Cost of Flexibility (2026 Rates) Choosing the POS option is expensive. You are responsible for paying the following out-of-pocket costs, which do not count toward your annual Catastrophic Cap:

* **POS Annual Deductible:** You must pay the first **$300 for individuals** or **$600 for families** (2026 rates) before TRICARE pays anything. * **POS Cost-Shares:** After the deductible is met, you pay **50% of the TRICARE-allowable charge** for all covered services. * **Excess Charges:** If you see a non-participating non-network provider, you may also be responsible for up to an additional 15% above the TRICARE-allowable charge.

### Important Exceptions The Point-of-Service option does **not** apply in the following scenarios: * **Emergency Care:** Life, limb, or eyesight emergencies never require a referral. * **Urgent Care:** Most TRICARE Prime enrollees (excluding active duty service members) can seek urgent care from a network provider without a referral. * **Preventive Care:** Periodic health exams or screenings from network providers typically do not trigger POS charges. * **Newbom/Adoptee Care:** The first 60 days of care for a newborn or newly adopted child.

### Why Active Duty Service Members (ADSMs) Should Avoid POS Active duty service members cannot use the Point-of-Service option. If an ADSM seeks care without a referral, the claim may be denied entirely, and the member may be held responsible for the full bill. The POS option is intended for family members and retirees.

## Who this affects * **Active Duty Family Members (ADFMs):** Enrolled in TRICARE Prime or TRICARE Prime Remote. * **Retirees and their Families:** Enrolled in TRICARE Prime. * **Transitional Assistance Management Program (TAMP) enrollees:** If using a Prime plan. * **Survivors:** Enrolled in TRICARE Prime.

## Sources * **TRICARE.mil:** [Point-of-Service Option](https://www.tricare.mil/pos) * **Humana Military (East):** [Referrals and Authorizations](https://www.humanamilitary.com/beneficiary/plans-and-programs/tricare-prime/point-of-service) * **TriWest Healthcare Alliance (West):** [Provider Network Information](https://www.triwest.com) * **Defense Health Agency (DHA):** [TRICARE Costs and Fees](https://www.tricare.mil/costs)