Uploaded June 2026 | Updated September 2026, 3 weeks ago
If you're stationed in Germany and struggling to get the medical care you need through the TRICARE network, this video is for you.
In this interview, I sit down with Shayla, a military spouse who suffered a serious ankle injury following a car accident. After months of difficulty finding the specialized treatment she needed through an in-network TRICARE provider, Shayla shares how she worked with her Primary Care Manager (PCM) to obtain an out-of-network referral and ultimately receive treatment from an orthopedic ankle specialist at OTC Regensburg.
We walk through the referral process step by step, discuss the differences between TRICARE Prime Overseas and TRICARE Select Overseas, explain the pros and cons of in-network vs. out-of-network providers, and cover the documentation you'll need if you require a TRICARE referral and reimbursement outside its network.
⚠️ Important: An out-of-network referral does NOT mean you won't pay anything upfront. Many German clinics, including specialists (such as the dentist offices), will more than likely require full payment before treatment. TRICARE may reimburse eligible expenses later, but reimbursement is not guaranteed and depends on your authorization, referral, and TRICARE rules. It's always important to ensure you will get reimbursed BEFORE you go through a costly procedure out-of-network. Check with your TRICARE representatives on base along with your PCM about billing.
Skip Ahead:
Who are you? 0:00
What happened? 0:15
The first surgery 2:38
TRICARE Prime vs Select 4:13
In network vs out of network 4:34
Bad German doctor 4:51
Good German doctor 5:42
OTC Regensburg 6:06
Out of network referral 6:11
OTC consultation 7:39
More referrals 8:26
How long did it take? 9:25
Advice 10:50
Did you hear "no" 11:23
Billing 11:53
Physical therapy 12:58
TRICARE Prime vs Select
TRICARE Prime Overseas:
- Most common option for command-sponsored military families in Germany
- Assigned a Primary Care Manager (PCM)
- Requires referrals for most specialty care, especially outside the TRICARE network
- Lower out-of-pocket costs when following referral procedures
TRICARE Select Overseas:
- Greater flexibility when choosing providers
- No PCM assignment
- No routine referral requirement for specialty care
- Potentially higher out-of-pocket costs depending on the provider and services received
In-Network vs. Out-of-Network Providers
In-Network Provider:
- Has a formal agreement with the TRICARE contractor
- Follows TRICARE billing and reimbursement procedures
- Often files claims directly
- Usually less paperwork for the patient
- May not require large upfront payments
Out-of-Network Provider
- Licensed and authorized to treat TRICARE beneficiaries but does not have a direct contract with TRICARE
- May require payment in full before treatment
- May charge more than TRICARE's allowable amount
- You may be responsible for the difference
- Requires additional documentation and approvals for reimbursement
What You Need for an Out-of-Network Referral
- Thorough medical documentation explaining why you require an out-of-network specialist
- Work with your PCM to request the referral
- Coordinate with the TRICARE Overseas Program contractor
- Obtain authorization before treatment whenever possible
- Keep copies of ALL medical records, invoices, and receipts
- Send German medical documents to your Military Treatment Facility (MTF) if translations are required
- Submit referrals and supporting documentation for every out-of-network service needed (consultations, imaging, surgery, anesthesia, follow-up care, etc.)
About OTC Regensburg
OTC Regensburg is a modern orthopedic and trauma surgery clinic serving both the German and international communities. Military families (especially in Bavaria) can use OTC for orthopedic evaluations, sports medicine, joint injuries, and surgical procedures when specialized care is needed.
Learn more about OTC Regensburg:
otc-regensburg.de/en/orthopedic-care-us-military
30 Things you MUST know before PCSing to Germany with the US military: dtvdanieltelevision.com/2022/01/03/30-things-you-must-know-before-pcsing-to-germany-with-the-us-military
“30 Things” Free Download: https://dtv-daniel-television.sellfy.store/p/free-30-things-you-must-know-before-pcsing-to-germany/
FREE PCS to Germany Checklist: danieltelevision.lpages.co/free-pcs-checklist
Ultimate PCS Checklist Binder: https://dtv-daniel-television.sellfy.store/p/the-ultimate-pcs-checklist-binder/
Website: dtvdanieltelevision.com
FB: https://m.facebook.com/dtvdanieltelevision
IG: instagram.com/dtv_danieltelevision
TikTok: tiktok.com/@dtvdanieltelevision
If you're stationed in Germany and struggling to get the medical care you need through the TRICARE network, this video is for you.
In this interview, I sit down with Shayla, a military spouse who suffered a serious ankle injury following a car accident. After months of difficulty finding the specialized treatment she needed through an in-network TRICARE provider, Shayla shares how she worked with her Primary Care Manager (PCM) to obtain an out-of-network referral and ultimately receive treatment from an orthopedic ankle specialist at OTC Regensburg.
We walk through the referral process step by step, discuss the differences between TRICARE Prime Overseas and TRICARE Select Overseas, explain the pros and cons of in-network vs. out-of-network providers, and cover the documentation you'll need if you require a TRICARE referral and reimbursement outside its network.
⚠️ Important: An out-of-network referral does NOT mean you won't pay anything upfront. Many German clinics, including specialists (such as the dentist offices), will more than likely require full payment before treatment. TRICARE may reimburse eligible expenses later, but reimbursement is not guaranteed and depends on your authorization, referral, and TRICARE rules. It's always important to ensure you will get reimbursed BEFORE you go through a costly procedure out-of-network. Check with your TRICARE representatives on base along with your PCM about billing.
Skip Ahead:
Who are you? 0:00
What happened? 0:15
The first surgery 2:38
TRICARE Prime vs Select 4:13
In network vs out of network 4:34
Bad German doctor 4:51
Good German doctor 5:42
OTC Regensburg 6:06
Out of network referral 6:11
OTC consultation 7:39
More referrals 8:26
How long did it take? 9:25
Advice 10:50
Did you hear "no" 11:23
Billing 11:53
Physical therapy 12:58
TRICARE Prime vs Select
TRICARE Prime Overseas:
- Most common option for command-sponsored military families in Germany
- Assigned a Primary Care Manager (PCM)
- Requires referrals for most specialty care, especially outside the TRICARE network
- Lower out-of-pocket costs when following referral procedures
TRICARE Select Overseas:
- Greater flexibility when choosing providers
- No PCM assignment
- No routine referral requirement for specialty care
- Potentially higher out-of-pocket costs depending on the provider and services received
In-Network vs. Out-of-Network Providers
In-Network Provider:
- Has a formal agreement with the TRICARE contractor
- Follows TRICARE billing and reimbursement procedures
- Often files claims directly
- Usually less paperwork for the patient
- May not require large upfront payments
Out-of-Network Provider
- Licensed and authorized to treat TRICARE beneficiaries but does not have a direct contract with TRICARE
- May require payment in full before treatment
- May charge more than TRICARE's allowable amount
- You may be responsible for the difference
- Requires additional documentation and approvals for reimbursement
What You Need for an Out-of-Network Referral
- Thorough medical documentation explaining why you require an out-of-network specialist
- Work with your PCM to request the referral
- Coordinate with the TRICARE Overseas Program contractor
- Obtain authorization before treatment whenever possible
- Keep copies of ALL medical records, invoices, and receipts
- Send German medical documents to your Military Treatment Facility (MTF) if translations are required
- Submit referrals and supporting documentation for every out-of-network service needed (consultations, imaging, surgery, anesthesia, follow-up care, etc.)
About OTC Regensburg
OTC Regensburg is a modern orthopedic and trauma surgery clinic serving both the German and international communities. Military families (especially in Bavaria) can use OTC for orthopedic evaluations, sports medicine, joint injuries, and surgical procedures when specialized care is needed.
Learn more about OTC Regensburg:
otc-regensburg.de/en/orthopedic-care-us-military
30 Things you MUST know before PCSing to Germany with the US military: dtvdanieltelevision.com/2022/01/03/30-things-you-must-know-before-pcsing-to-germany-with-the-us-military
“30 Things” Free Download: https://dtv-daniel-television.sellfy.store/p/free-30-things-you-must-know-before-pcsing-to-germany/
FREE PCS to Germany Checklist: danieltelevision.lpages.co/free-pcs-checklist
Ultimate PCS Checklist Binder: https://dtv-daniel-television.sellfy.store/p/the-ultimate-pcs-checklist-binder/
Website: dtvdanieltelevision.com
FB: https://m.facebook.com/dtvdanieltelevision
IG: instagram.com/dtv_danieltelevision
TikTok: tiktok.com/@dtvdanieltelevision
