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X Marks the Spot When Changing Your PCM (Article 2) |
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Changing your primary care manager (PCM) may be done at any time as long as the new PCM is accepting new patients and your request complies with local military treatment facility (MTF) Commander guidelines.
Once you have selected either a new MTF provider or a new PCM (use the HMHS Provider Locator for assistance locating a PCM), complete a TRICARE Prime Enrollment and PCM Change Form using the new PCM’s name and address.
You only need to complete the portion of the form related to the PCM change. Mark an “X” in the PCM Change box
and complete sections I, IV and VI of the form. TRICARE Prime Remote enrollees must also complete section V.
The change will become effective once the change form is received and processed at Humana Military. |
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| Step by Step |
| 1. Mark an “X” in the PCM Change box, located at the top of the form |
| 2. Complete Section I—Sponsor information |
3. Complete Section IV—Reason for PCM change
–Print the name of each affected family member.
–Check the reason for change; if “Other,” explain. |
| 4. Complete Section VI—Signature and date |
| 5. Complete Section V—ONLY if you are enrolled in TRICARE Prime Remote |
6. Mail to:
Humana Military Healthcare Services
ATTN: PNC Bank
P.O. Box 105838
Atlanta, GA 30548-9758 |
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Last Reviewed: December 4, 2007
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