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Changing your primary care manager (PCM) is a simple process if you are a TRICARE Prime beneficiary.
When you enrolled in TRICARE Prime you selected, or were assigned to, a PCM who has provided and coordinated all of your health care services. Your PCM understands your medical history and your health care needs.
But, if you decide it’s time for a new PCM, you can select a new PCM as long as the new provider you’ve chosen is accepting new patients and your request complies with military treatment facility (MTF) guidelines. If you live within 40 miles of a military hospital or clinic, you may be required to select a military PCM.
To see a listing of civilian PCMs in your region, select a new PCM from the Humana Military Provider Locator. You can search the locator by distance or by name.
Once you’ve selected a new provider who is accepting new patients, complete a TRICARE Prime Enrollment and PCM Change Form with the new PCM’s name and address.
Only network providers can serve as civilian PCMs under the TRICARE program. However, not all network providers choose to be PCMs. To be a PCM, a provider must agree to do so and have an appropriate medical specialty (such as internal medicine, pediatrics and obstetrics).
If you change from one MTF provider to another, the change will be effective immediately. If you change your network provider or switch from an MTF to a TRICARE network provider, the change becomes effective when your change form is processed.
If the form is received on or before the 20th of the month, the change is effective on the first day of the following month. If it’s received after the 20th of the month, the change will be effective on the first day of the next month. The 20th of the month rule gives Humana Military sufficient time to record the change, which prevents point-of-service charges and other unnecessary claims issues.
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