The Pentagon plans to restrict further the access of military families to non-emergency medical care at civilian hospitals. Under current rules, most families living within 40 miles of a military hospital must get a waiver before the military will pick up the cost of their in-patient treatment at a civilian hospital. Starting Jan. 1, the Defense Department plans to tighten the standards for granting a waiver.

"The overall thrust of the new initiatve is to reduce the use of civilian medical facilities by military families who reside within 40 miles of a military hospital and preserve CHAMPUS [Civilian Health and Medical Program of the Uniformed Services] benefits for those families who live too far away to use military hospitals," said Deputy Defense Secretary Frank C. Carlucci.

The program is deep into red ink, $122 million in fiscal 1982 and probably double that in fiscal 1983, DOD officials said. Carlucci said the "cost reduction initiatives" were being put in place as a way to save nearly $47 million in fiscal 1983. Emergency care won't be affected by the change, but in January, permits for non-emergency in-patient care will be issued only when military hospitals don't have room for a military family member.

The situation is a little different for the Washington area. For the first time, the Pentagon will establish a 40-mile zone for the five military hospitals: Bethesda National Naval Medical Center, the Walter Reed Army Medical Center, Malcolm Grow Air Force Medical Center at Andrews Air Force Base, DeWitt Army Medical Hospital at Fort Belvoir and Kimbrough Army Hospital at Fort Meade. Exceptions will be made, though, for families who live south of Quantico Marine Corps Base or in Baltimore county.