Choices Enrollment Handbook

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TRICARE Prime Enrollment Fees
US Family Health Plan
TRICARE Standard and TRICARE Extra
TRICARE For Life

Step 4: Enroll or Begin Using TRICARE Coverage

TRICARE Prime Enrollment Fees

Retired service members, their families, survivors, eligible former spouses, and others (e.g. Medal of Honor recipients) enrolled in TRICARE Prime are required to pay an annual enrollment fee. In most cases, the TRICARE Prime enrollment fees are not refundable. There are no enrollment fees for ADSMs and ADFMs (or for survivors during the transitional survivor period following the ADSM’s death) enrolled in TRICARE Prime, TPR, or TPRADFM.

Refer to the TRICARE: Summary of Beneficiary Costs Flyer for TRICARE Prime enrollment fee amounts and payment options.

 
US Family Health Plan

If you choose to enroll in the US Family Health Plan (USFHP), you must submit a completed application to the USFHP program near you. The TRICARE Prime Enrollment Application and PCM Change Form serves as the enrollment application for USFHP and has the USFHP address indicating where to send your enrollment form. Refer to “TRICARE Prime Options” in this section to learn more about completing this form.

You may enroll at any time throughout the year; however, you make a one-year commitment to receive your care from the plan, unless you move out of the plan service area. Enrollment fees, if applicable, are transferrable to another TRICARE Prime region.
Tips for Completing the Enrollment Application                                                                                    Figure 5.2

Enrollment
Application

 		 There is an enrollment application for TRICARE Prime, TPR, and TPRADFM— the TRICARE Prime Enrollment Application and PCM Change Form. The only thing that varies on the form in each region is the address to return your completed form. Your regional contractor’s name and address are found in the mailing instructions on page 4 of the enrollment application. Remember, you only need one enrollment application for your entire family (unless utilizing the split enrollment option for TRICARE Prime). You may need a second form if you have more than three family members or at least copies of the family member information page (Section II).
Selecting a PCM  
  • If you live in a TRICARE Prime service area, contact your regional contractor to verify any MTF guidelines for PCM assignment.

  • If you are choosing a network PCM, contact the PCM’s office to make sure the provider is accepting new patients.

  • If you do not indicate a PCM on the enrollment form or if your choice is not available, one will be assigned to you.

  • Remember to choose a PCM for each person enrolling.

  • If enrolling in TPR or TPRADFM, you may not have an assigned PCM. Contact your regional contractor for assistance.
Medicare
Eligibility 		If any family member is entitled to Medicare Part A, regardless of age, fill out Section III of the form and include copies of each Medicare card. ADFMs and beneficiaries enrolling in the USFHP are not required to have Medicare Part B coverage to remain eligible to enroll in TRICARE Prime or USFHP, however, all others (e.g., retired service members, their families, and others) must have Medicare Part B coverage to remain eligible for TRICARE. TRICARE Prime enrollment fees will be waived if entitlement to Medicare Part A is based on disability or endstage renal disease.

 

TRICARE Standard and TRICARE Extra
There is no enrollment process for TRICARE Standard or TRICARE Extra. However, your personal information in DEERS must be up to date, and you must have a valid military identification (ID) card. Visit the online Provider Directory to  find a list of TRICARE authorized providers. Remember, you can save yourself money by using the TRICARE Extra option and seeing a TRICARE network provider.

TRICARE For Life
TRICARE For Life (TFL) is administered by Wisconsin Physicians Service (WPS). If you are eligible, visit TRICARE4U  or contact WPS at 1-866-773-0404. While there is no enrollment process for TFL, you must have Medicare Part B coverage (see exceptions listed in the Eligibility for TRICARE section of this book).

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Last Reviewed: February 29, 2008