Space-available care at LRMC explained

Courtesy of Landstuhl Regional Medical Center Public Affairs

Space-available health care is available at Landstuhl Regional Medical Center in certain clinics, but the number of available appointments can vary widely according to variables such as hospital staffing, Army transformation and support for its wartime mission. To help explain the Space-A policy and how it works, Capt. Rob Davis, chief of clinical operations, offers the following information.

Q: What is the policy for space-available care at LRMC?
A:  According to Department of Defense and TRICARE policy, hospital commanders may offer medical care to people who are not TRICARE-eligible (e.g. general schedule federal employees, Army and Air Force Exchange Service and Department of Defense Dependents Schools civilian employees) as provider and clinical availability allow and on a fully reimbursable basis. Military treatment facilities overseas cannot guarantee the availability of space-available appointments.

Q:  Approximately how many space-available appointments are available at LRMC on a typical day, week or month?
A:  The number of appointments depends on the clinic, the service provided and the number of appointments available. You can call 590-LRMC (5762) or 06371-9464-LRMC (5762) to find out if a specific clinic is currently offering space-available appointments.

Q:  Why does it seem there are often so few appointments available? What are the limiting factors that prevent LRMC from seeing more?
A: LRMC is the only DOD medical center in Europe offering primary care and specialty services, and we offer that care to more than 42,000 TRICARE enrolled beneficiaries. The clinics are staffed and funded to meet the needs of these enrolled beneficiaries, which is why there is a limited number of space-available appointments.

LRMC and other military treatment facilities provide health care to its beneficiaries according to the following basic priorities:

Priority 1: Active-duty service members

Priority 2: Active-duty family members who are enrolled in TRICARE Prime

Priority 3: Retirees and their family members who are enrolled in TRICARE Plus

Priority 4: Active-duty family members who are not enrolled in TRICARE Prime (i.e. TRICARE Standard)

Priority 5: All other TRICARE eligible persons

Priority 6: Non-TRICARE eligible persons (e.g. general schedule federal employees, AAFES and DODDS civilian employees)

Q: With the ongoing transformation and reduction of forces in Europe, do you anticipate increasing or reducing the possibility of space-available appointments?
A: LRMC anticipates fewer space-available appointments because of population changes in Europe secondary to Army transformation.  It is not recommended to rely on space-available appointments for your ongoing health care needs.

Q: What is the correct procedure for trying to be seen space-available?
A: Patients should call the local appointment line (06371-9464-5762) to try and book an appointment. Landstuhl is currently not offering primary care space-available appointments, but the clinic in their area may be offering space-available primary care appointments.

Q: What if I need a referral to a specialty clinic at LRMC that sees space-available patients, but I cannot get an appointment in Primary Care to initiate the referral?
A: Contact the LRMC Referral Management Center at or call the LRMC TRICARE Service Center at 590-4830 or 06371-9464-4830 and ask for Referral Management.

Q:  If I am able to be seen Space-A and my doctor said I needed a follow-up appointment, would that be included as part of my original visit or would I need to book that appointment as well through Space-A?
A: It is up to the clinic to determine whether or not a follow-up appointment would be included as part of your original visit. It is important to remember that a follow-up appointment is not guaranteed, and many primary care clinics that are currently seeing Space-A are not providing follow-up appointments. You are only entitled to that original appointment.

Q:  What options are available when Space-A isn’t available?
A: If an appointment isn’t available at a military treatment facility, beneficiaries can use a host nation provider on the local economy. Your local TRICARE service center can provide a listing of local host nation providers. A list of local host nation providers is available at For example, a recent search on that site offered five pediatric clinics in the Baumholder area and six internal medicine choices for Schweinfurt.
In Germany, providers usually ask for up-front payment before providing health care. Medical costs are reimbursable through the patient’s health insurance provider. U.S. civilian personnel are required by the government to have health insurance coverage when they arrive in Europe.

More information is available from the U.S. Army Civilian Human Resources Agency-Europe Region website under the “Living and Working Overseas” link at

Q:  What are the advantages of being seen by a doctor on the local economy?
A:  Establishing care with a primary care manager on the economy ensures the non-TRICARE eligible patient primary care access and continuity of care for them and their family while living in the KMC. Patients can contact the local TRICARE service center for assistance in locating an English speaking provider on the economy.

Q: I don’t speak German. How would I go about booking an appointment?
A:  A comprehensive “Your Guide to Host Nation Health Care” is available for each Army military community. The guide provides practical information such as maps to host nation facilities, driving directions and specific information about each facility. The guide can be found on the LRMC public website homepage at

TRICARE beneficiaries can receive assistance in scheduling appointments with a host nation provider through the managed care support contractor, international SOS at, or in some instances, from your servicing TRICARE service center. For non-TRICARE beneficiaries, contact the servicing insurance company for assistance with benefits, scheduling and/or claims.

You can receive assistance during your inpatient stay at a facility on the local economy by contacting a host nation patient liaisons at your local TRICARE service center who:

» assists U.S. beneficiaries hospitalized in host nation medical facilities.

» helps plan your transfer from a military treatment facility to a host nation medical facility, or from a host nation facility to a military treatment facility.

» eases language barriers between the patient and host nation providers.

» talks to your host nation physician to get up-to-date information on your medical condition and treatment plan.

» answers questions about treatment, environment of care and follow-up care to the best of their knowledge or when doctors are unavailable.

» assesses and interprets patient concerns to determine specific assistance needs.

» assists with the discharge of a patient from a host nation hospital.

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