TRICARE for National Guard and Reserve

            
TRICARE Prime Remote and
TRICARE Prime Remote for Active Duty Family Members

TRICARE Prime Remote (TPR) and TRICARE Prime Remote for Active Duty Family Members (TPRADFM) offer TRICARE Prime benefits to beneficiaries who work and live in designated TPR locations—areas that are more than 50 miles or an hour’s drive time from an MTF. Eligibility for TPR and TPRADFM is determined by the ZIP code where you live and the ZIP code where you, the sponsor, work. Visit the TRICARE Web site to see if your work and residence ZIP codes are in a TPR location.

Family members who live with you in a TPR location when you are activated are eligible for TPRADFM. They will remain eligible for TPRADFM as long as they live in the same location throughout your activation period. Family members who choose not to enroll in TPRADFM may continue to use TRICARE Standard and TRICARE Extra.

When you report to your final duty station, you will submit a TRICARE Prime Enrollment Application and PCM Change Form (DD Form 2876) to Humana Military. If your eligible family members wish to enroll in TPRADFM, you will include them on the enrollment form. Your TPR enrollment is effective when Humana Military receives your enrollment form. For family members, the form must be received by the 20th of the month for coverage to begin on the first day of the next month. Family members remain covered by TRICARE Standard and TRICARE Extra until TPRADFM coverage begins.

You will receive most care from an assigned PCM, if one is available. If not, primary care may be received from any TRICARE-authorized provider. To locate a provider, visit TRICARE's Web site or call Humana Military. Contact the provider directly to schedule an appointment.

Your family members must have a PCM or primary care provider referral before getting specialty care, and the care may need to be authorized by Humana Military prior to being received. Family members without an assigned PCM may need to obtain authorization for care directly from Humana Military. 

Humana Military has additional prior authorization requirements. Visit Humana Military’s Prior Authorization list or call 1-800-444-5445 to learn about their requirements, as they may change periodically.

The point of service (POS) option allows family members to receive nonemergency care from any TRICARE-authorized provider without first requesting a referral from their PCM. Using the POS option will result in higher out-of-pocket costs.

Note: Activated National Guard and Reserve members may not exercise the POS option.

Refer to your TRICARE Prime Remote Handbook and the TRICARE: Summary of Beneficiary Costs brochure for more information about TPR and TPRADFM, including costs for covered services and POS fees.

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