from a civilian source. By failing to secure such a statement, the beneficiary may waive
his right to benefits under TRICARE.
(8) DD Form 1251 (Non-availability Statements). See figure 1 -1. These
statements are issued by the hospital commander when necessary. The form should
be requested in advance of medical care except for emergencies. It must be filed with
the applicable TRICARE claim.
1-11. ENTITLEMENT TO OUTPATIENT CARE UNDER TRICARE
a. Outpatient Care refers to any medical services rendered to a person not
confined as a registered bed patient in a hospital or other authorized institution. For
example, medical care provided in the home or office, or in the outpatient department of
a hospital, infirmary, or other authorized institution is outpatient care.
b. All TRICARE beneficiaries may obtain outpatient medical care from either
uniformed services or civilian medical treatment facilities WITH THE EXCEPTION OF
ADJUNCTIVE DENTAL TREATMENT AND PASTORAL, FAMILY, CHILD, AND
MARITAL COUNSELING. These services require prior approval. Except/for the
situations described in paragraph 1 -10, prior approval and/or non-availability statements
are not required. However, patients are advised to check with the Health Benefits
Advisor in the nearest military MTF prior to using civilian MTFs for outpatient care.
1-12. HEALTH BENEFITS NOT COVERED UNDER TRICARE
a. Abortions, except when the mother's life is in danger. The attending
physician must certify in writing that the abortion was performed because a life-
endangering condition existed, and must provide medial documentation to the
TRICARE claims processor in order for TRICARE Standard to share the cost of the
procedure.
b. Acupuncture.
c. Artificial insemination or any forms of artificial conception. This noncoverage
includes in vitro fertilization and gamete intrafallopian transfer, as well as all other non-
coital reproductive methods and all services, supplies and drugs related to them.
d. Autopsy services or post mortem examination.
e. Birth control for whic h you do not need a doctor's prescription. TRICARE
Standard will, however, cost-share some kinds of birth control.
f. Bone marrow transplants for treatment of ovarian cancer except for
Department of Defense/National Cancer Institute demonstration project for breast
cancer. This project has allowed TRICARE patients access to promising cancer
therapies and has been expanded to include other cancers as well.
MD0755
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