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TRICARE PRIME
HANDBOOK
Your guide to program benefits
TABLE OF CONTENTS
Welcome to TRICARE Prime
Getting Started
TRICARE Provider Types
Your Primary Care Manager
Enrollment Card
Disenrollment
Getting Care
Making an Appointment
Access Standards for Care
Emergency Care
Urgent Care
Routine (Primary) Care
Speciality Care
Prior Authorizations for Care
Getting a Second Opinion
Point of Service Option
Covered Services, Limitations, and Exclusions
Outpatient Services
Inpatient Services
Clinical Preventive Services
Behavioral Health Care Services
Pharmacy Services
Maternity Services
Dental Options
Services or Procedures with Signigicant Limitations
Exclusions
Claims
Health Care Claims
Pharmacy Claims
Coordinating Benefits with Other Health Insurance
Third-Party Liability
Explanation of Benefits
Debt Collection Assistance Officers
Life Events
Getting Married or Divorced
Having a Baby or Adopting a Child
Going to College
Traveling
Moving
Separating from the Service
Retiring from Active Duty
Becoming Entitled to Medicare
Deceased Sponsor
Loss of Eligibility
Information and Assistance
Beneficiary Counseling and Assistance Coordinators
Appealing a Decision
Filing a Grievance
Reporting Suspected Fraud or Abuse
Your TRICARE Regional Contractor
Keep Your DEERS Information Current
Important Note for National Guard and Reserve Members and Their Families
Patient Bill of Rights
Important Information
Acronyms
Glossary
South Region Explanation of Benefits Statement Sample
How to Read Your TRICARE EOB for the South Region
List of Figures
Back to Top
Last Reviewed: July 11, 2008
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