Blog Archives

Beware of Local “Emergency Centers” Not Authorized by TRICARE

TRICARE beneficiaries may have noticed new kinds of “Emergency Centers” popping up in their area. It may seem like a tempting health care option but, free-standing emergency rooms (ER) that are not affiliated with a hospital may not be TRICARE-authorized. If a provider, such as a free-standing ER, is not authorized then TRICARE is prohibited from paying it “facility fees.” That can leave a beneficiary stuck with a big bill. Beneficiaries need to “know before you go.”  Check a free-standing...

TRICARE and ABA Therapy for Autism Ruling

On July 26h, 2012, a United States Federal Judge ordered TRICARE to begin paying for Applied Behavior Therapy (ABA) for dependents with autism. Active duty service members are able to receive services through TRICARE’s Extended Health Care Option (ECHO) program, which defined ABA therapy as a medical intervention. Retirees are unable to receive ECHO benefits. Under TRICARE Basic, ABA therapy was defined as an educational intervention, not a medical intervention, making it ineligible for TRICARE coverage. ABA therapy,...

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