Prime Remote Handbook

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Getting a Second Opinion
Point of Service Option for Family Members
               
Getting a Second Opinion
You have every right to request a consultation with another provider for a second medical opinion when the initial provider is uncertain about a contemplated course of action. You, your PCM, or Humana Military may request a second medical opinion. If you wish to get a second opinion, you must first get a new referral from your PCM. Go to your PCM and explain your situation and any questions you may have about the first specialist’s suggested care. Then, ask your PCM to coordinate a referral to another specialist and request a referral from Humana Military if necessary. Active duty service members will also need SPOC approval.

             
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Point of Service Option for Family Members

The point of service (POS) option gives active duty family members the freedom to seek and receive nonemergency health care services from any TRICARE-authorized provider without requesting a PCM or regional contractor referral, resulting in higher out-of-pocket costs. See the TRICARE: Summary of Beneficiary Costs flyer to learn about POS fees.

The POS option does not apply to the following:
       

  • Active duty service members
  • Newborns or adopted children in their first 60 days
  • Emergency care
  • Preventive care services from a network provider
  • First eight behavioral health outpatient visits from a network provider
  • If you have other health insurance

             
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Last Update: July 30, 2008