What is required for a beneficiary if referred for specialty care under TRICARE Prime?

When a beneficiary is referred for specialty care under TRICARE Prime, obtaining a referral from their Primary Care Manager (PCM) is essential. The PCM serves as the first point of contact for health care and is responsible for coordinating the patient's care, which includes referrals to specialists. This process ensures that the patient receives the appropriate level of care and that the treatment aligns with their overall health plan.

Having a PCM referral is crucial because it helps manage costs and ensures that the care provided is necessary and appropriate. It also helps streamline communication between the health care providers and the beneficiary's primary care team, which can lead to better outcomes and continuity of care. Overall, the referral process is a key component of the TRICARE Prime system, which prioritizes efficient and coordinated care for beneficiaries.

Other options mentioned do not comply with TRICARE Prime guidelines, which is why they do not fulfill the requirement for obtaining specialty care.