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Prime Remote Handbook
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Frequently
Asked
Questions |
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Can I choose my own provider? |
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Yes, as long as the provider is currently accepting new TRICARE patients. If there is more than one network provider in your area, you have the freedom to choose one that is convenient for you. If you are in an area with no network providers, you may use any TRICARE-authorized provider. Contact Humana Military for assistance. |
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How do I get emergency medical care? |
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If you need emergency medical care, go to the nearest military or civilian emergency room or call 911. Active duty service members should contact their primary care manager (PCM), regional contractor, or service point of contact (SPOC) as soon as possible after getting emergency treatment or being admitted to a hospital. Family members should contact their PCM or primary care provider so that ongoing care can be coordinated. Additional authorization for care from Humana Military may be necessary. Refer to Humana Military’s Web site for referral and authorization requirements. |
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How do I get care if there are no TRICARE network providers where I live? |
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If there are no TRICARE network providers in your area, you may get care from any approved TRICARE-authorized provider. To locate a TRICARE-authorized provider, you can use the online provider directory or contact Humana Military. |
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How do my claims get paid? |
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Specific information on where to file your claims is available in the Claims section of this handbook. Active duty service members may contact the SPOC for claims denied by the SPOC as indicated on your TRICARE explanation of benefits in the remarks section. |
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What if I have a serious illness that can affect my fitness-for-duty status? |
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The uniformed services (Army, Navy, Marine Corps, Air Force, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration) are responsible for making sure all active duty service members are qualified for worldwide service.
If there is a question about your continued ability to perform your assigned duties or stay on active duty, your SPOC will refer you to the nearest MTF with the specialty care you require to make a qualified evaluation.
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How is TPR/TPRADFM different from the TRICARE Prime? |
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It’s not. TPR and TPRADFM is TRICARE Prime in remote duty stations. The regular TRICARE Prime program usually provides health care in MTFs and is augmented by civilian TRICARE network providers. Getting care at an MTF is difficult if you live and work far from an MTF. TPR and TPRADFM allow you to visit local health care providers with the same costs as if you were visiting an MTF. |
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What if the provider wants payment up front? |
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Some nonparticipating providers may ask for payment at the time of your visit. If this happens, you may have to pay an out-of-pocket cost, but TRICARE will reimburse you fully for TRICARE-covered benefits when you submit a claim for payment. See the Claims section for more information about filing health care or pharmacy claims. |
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