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TRICARE Prime Travel Entitlement
Getting Care While Traveling

TRICARE Prime Travel Entitlement
If you are referred by your PCM for specialty care at a location more than 100 miles from your PCM, you may be eligible to have your “reasonable travel expenses” reimbursed by TRICARE. You must have a valid referral and travel orders from a TRICARE representative at the MTF where you are enrolled or from the TRICARE Regional Office if your PCM is a TRICARE network provider.

Reasonable travel expenses are the actual costs incurred when traveling such as meals, gas/oil, tolls, parking, and tickets for public transportation (i.e. airplane, train, bus, etc.). You must submit receipts for expenses above $75. You are expected to use the least costly mode of transportation, and government rates will be used to estimate the reasonable cost. The actual costs of lodging (including taxes and tips) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.

A parent, guardian, or other adult family member* is authorized to travel with a non-active duty Prime-enrolled patient as a non-medical attendant (NMA). If the NMA is not the parent, he or she must be 21 years of age. The NMA is not required to be enrolled in TRICARE Prime or to be TRICARE-eligible. The patient, however, must be enrolled in TRICARE Prime.


This entitlement does not apply to expenses incurred by active duty service members or active duty family members residing with their sponsors overseas, which are reimbursed by other travel entitlements.

Prime Travel and Non-Medical Attendant Entitlements

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Getting Care While Traveling
For emergencies while traveling away from home, you should dial 911 or go directly to the nearest hospital emergency department. You (or family members on your behalf) should notify your PCM or your regional contractor within 24 hours of receiving emergency medical care to allow your doctor the opportunity to arrange for your continuing treatment.

For treatment of a nonemergency medical condition that cannot wait until you return home, you should coordinate with your PCM before seeking care. You may also call the Humana Military TRICARE Service Line at 1-800-444-5445 any time of day or night for assistance in coordinating out-of-area care. If you do not receive a referral from your PCM that has been authorized by Humana Military for nonemergency care obtained out of area, your care may be covered under the point-of-service (POS) option, which includes a deductible, higher co-payments, and cost-shares.

 
*By statute, the NMA must be a parent, legal guardian, or other adult family member. If the NMA family member is active duty or a DoD civilian employee authorized by the MTF or TRICARE Regional Office to accompany a nonactive duty TRICARE Prime enrollee as an NMA, he or she is entitled to TDY allowances (per diem and mileage), not actual expenses. If the NMA family member is a civilian not employed or affiliated with the DoD, they are authorized for reimbursement of reasonable travel expenses incurred.


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Last Reviewed: September 4, 2007