Prime Remote Handbook
 

Table of Contents            Next Page
   
  Image of TRICARE Prime Remote Handbook cover TRICARE
Prime
Remote
Handbook
Your guide to Prime program benefits
for active duty service members and their families.
Table of Contents
   
  Important Information
  Welcome
  Your Regional Contractor
  Service Point of Contact for ADSMs
              
Eligibility and Enrollment
  Active Duty Service Members
  Active Duty Family Members
  National Guard and Reserve Members
  National Guard and Reserve Family Members
             
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
  Specialty Care
  Prior Authorizations for Care
  Getting a Second Opinion
  Point of Service Option for Family Members
             
Covered Services, Limitations, and Exclusions
  Outpatient Services
  Inpatient Services
  Clinical Preventive Services
  Behavioral Health Care Services
  Behavioral Health Care Services Details
  Pharmacy Services
  Maternity Services
  Dental Options
  Dental Prior Authorizations
  Services or Procedures with Significant 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
  Filling Prescriptions on the Road
  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 an Appeal
  Filing a Grievance
  Reporting Suspected Fraud and Abuse
  Maintaining Your Medical Records
          
Frequently Asked Questions
               
Acronyms
              
Glossary
   
List of Figures
   
Appendix
  South Region Explanation of Benefits Statement Sample
  How to Read Your TRICARE EOB
   
  Patient Bill of Rights and Responsibilities
Last Reviewed: May 30, 2007