Does Tricare Select Require Authorization?
Tricare Select, a popular health insurance plan for military personnel and their families, often raises questions about the authorization process. One common query among policyholders is whether or not Tricare Select requires authorization for certain medical services. In this article, we will delve into this topic and provide a comprehensive understanding of the authorization process in Tricare Select.
Understanding Tricare Select
Tricare Select is a health insurance plan offered by the United States Department of Defense. It is designed to provide coverage for active-duty military personnel, retirees, and their families. The plan offers a wide range of benefits, including inpatient and outpatient care, prescription drugs, and dental and vision coverage. However, like any insurance plan, Tricare Select has certain requirements and limitations that policyholders should be aware of.
Authorization Process in Tricare Select
One of the key aspects of Tricare Select is the authorization process. While the plan covers a wide range of medical services, certain procedures and treatments may require prior authorization. This process ensures that the services requested are medically necessary and align with the plan’s guidelines.
When Does Tricare Select Require Authorization?
Tricare Select generally requires authorization for the following services:
1. Specialty Care: Patients may need authorization for visits to specialists, such as cardiologists, oncologists, and orthopedic surgeons.
2. Outpatient Procedures: Certain outpatient procedures, such as certain surgeries and diagnostic tests, may require prior authorization.
3. Prescription Drugs: Some medications, particularly those considered to be brand-name or non-formulary, may require prior authorization.
4. Dental and Vision Services: While Tricare Select offers dental and vision coverage, certain services, such as braces or Lasik surgery, may require authorization.
How to Obtain Authorization
To obtain authorization for a covered service in Tricare Select, patients should follow these steps:
1. Consult with Your Primary Care Manager (PCM): Your PCM can help determine if your requested service requires authorization and guide you through the process.
2. Complete the Authorization Form: Once your PCM determines that authorization is needed, they will provide you with the necessary form to complete.
3. Submit the Form: Send the completed authorization form to the appropriate Tricare office or healthcare provider.
4. Wait for Approval: Tricare will review your request and provide a decision on whether the service is authorized.
Conclusion
In conclusion, Tricare Select does require authorization for certain medical services. Understanding the authorization process is crucial for policyholders to ensure that their coverage is not affected. By following the outlined steps and consulting with your PCM, you can navigate the authorization process effectively and receive the care you need.
