payment by the Government will be denied. In this event institutionalized patients may
remain at Government expense until arrangements can be made for their transfer.
g. Qualifications of Professional Personnel. Civilian professional personnel
must be licensed if engaged to furnish medical care for TRICARE. Those in sciences
allied to the practice of medicine must also be licensed to practice. However, if their
services are to be a part of the required medical care, they may be used only upon the
written request of a licensed physician. Payment for chiropractic and acupuncture
services are not authorized.
EXTENT OF CARE
Both inpatient and outpatient health care benefits are provided through the
TRICARE program. The program will pay for medically necessary services and
supplies in the diagnosis and treatment of illness or injury including maternity care.
Benefits include specified medical services and supplies provided to eligible
beneficiaries from authorized civilian sources such as hospitals and other authorized
institutional providers as well as from physicians and other authorized individual
professional providers. They also include professional ambulance service, prescription
drugs, authorized medical supplies, rental of and, under certain conditions, purchase of
durable medical equipment.
ENTITLEMENT TO INPATIENT CARE UNDER TRICARE
All TRICARE beneficiaries are required to use uniformed services medical
treatment facilities for inpatient care, except:
a. In an emergency.
b. When residing outside the catchment area that provides inpatient care. The
catchment area is established by TMA-WEST, utilizing postal Zip Codes.
c. When it has been determined that issuance of a nonavailability statement is
1-10. CRITERIA FOR NONAVAILABILITY STATEMENT
a. Responsibility. MTF commanders are responsible for determining whether
uniformed services medical treatment facilities in an overlapping catchment area are not
available for use by TRICARE beneficiaries.