What are the two primary reasons for referrals being sent out of the network?

The correct response highlights the importance of service availability when it comes to referrals being sent out of a network. When a patient requires care that cannot be provided within the Military Treatment Facility (MTF) or fails to meet the access-to-care (ATC) standards, a referral is often necessary. This situation can arise if the MTF does not have the requisite specialty services or equipment, or if there's a backlog of patients causing delays that exceed the acceptable wait times for treatment.

Understanding this context is crucial because it demonstrates how healthcare systems prioritize patient access and quality of care over convenience or personal preference. Referrals based on service availability ensure that patients receive timely and appropriate medical attention, which is especially vital in a managed care environment.