Tricare Prime: Overview & Enrollment

Good Afternoon Everyone!
I've opted to break up each Tricare plan options into multiple posts each to avoid having one five mile long post for each one.

The first and most popular Tricare option is Tricare Prime.

Tricare Prime is Tricare's HMO coverage option.  This option has the least out of pocket costs but also the least freedom of choice of health providers.

You have a PCM (Primary Care Manager/Primary Physician) that manages most of your care and writes you referrals for any specialized care.  Your PCM will also work with regional contractors for referrals and will file claims for you.

Care is usually provided at a military medical facility however if there is not room at the local facilities, you may sent to a civilian provider.

Costs:

Annual Enrollment Fee: No fee for Active Duty or Active Duty family.  Retired, retired family, survivors, former spouses and others pay an annual fee that is applied to the catastrophic cap.

Other Costs: Nothing out of pocket for any type of care unless using the point of service option* for active duty and families.  All others are subject to co-pays and some cost shares.  Visit Tricare's website here for a breakdown of those costs.

Prescriptions: These do carry an additional cost and will be covered in a future post.

Enrollment:
Call your regional provider to enroll.  Make sure all the information in DEERS is current and correct before calling.
North: Health Net 1-877-874-2273
South: Humana 1-800-444-5445
West: UnitedHealthcare 1-877-988-9378


*Future post on this option coming soon

Be on the look out for more detailed posts for Tricare Prime coming up soon!

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