Referrals & Prior Authorization

Referrals

Your TRICARE Prime Demo plan does not require you to get a referral to see a network specialist. If your PCM or you want to get care from a non-network specialist, your PCM or you can request a pre-authorization from CSMV.

Prior Authorization (Pre-Authorizations)

Some services need to be approved by us before you can get them. Pre-authorization is the approval that may be needed before you get a service. It must be medically necessary for your care. Your network provider will get preauthorization for the care you need. Network or in-network means that these providers see CSMV beneficiaries. Use our Find a Doctor tool (Florida | Georgia) to find one near you.

View the full list of services that need pre-authorization (coming soon). Emergency care does not need pre-authorization.

Learn more about referrals and pre-authorizations in your beneficiary handbook.