Humana-Military.com

Image of a clock in a TRICARE South provider's waiting room



Waiving TRICARE Access Standards for Primary Care

May be Required if You Live Far from the MTF

If you are a non-active duty TRICARE beneficiary using TRICARE Prime, a military treatment facility (MTF) may be your first choice when it comes to where you and your family receive health care. Assignment of a primary care manager (PCM) at an MTF is determined by provider availability and the MTF’s policy for the TRICARE Prime Service Area.

TRICARE has access standards in place to help ensure you receive timely health care. The drive-time access standard states that your PCM should not be located more than 30 minutes’ drive time from your home address.  Visit the Humana Military provider locator to view drive times.

If you are a non-active duty benefi ciary in the 50 United States and you live more than 30 minutes’ travel time from the MTF where you want to enroll, you must waive TRICARE’s access standards using one of the following options:
Note: A signed waiver is also required when choosing a civilian PCM outside the access standards.

If you live more than 30 minutes but less than 100 miles from the MTF, your waiver request must be approved by the MTF. The MTF must also approve any waivers for those living 100 miles or more from the MTF.

If your waiver is approved, it remains in effect through your current enrollment period, as long as you don’t change your residence. Since an MTF’s provider availability can change over time, the MTF may not always renew your waiver at the end of your enrollment period. If this happens, Humana Military will notify you at least two months before your enrollment expires.

If your request is initially denied or your waiver is not renewed at the end of your enrollment period, you have several other TRICARE options. These include:
  • Enrolling at another MTF within your area
  • Enrolling with a civilian PCM if you live in or within 100 miles of a TRICARE Prime Service Area
  • Enrolling in the US Family Health Plan if you live in an area where it is offered
  • Using TRICARE Standard and TRICARE Extra for your health care needs
With several options available to you and your family, TRICARE is working every day to provide you and your family the best access to its world-class health care system.

Back to Top
 
Last Update: June 9, 2009