 TRICARE Prime Split Enrollment
An Option for College Students
Did you know that your child’s coverage in TRICARE Prime doesn’t have to end simply because he or she is moving away to college? If your child will be attending college where TRICARE Prime is offered, then he or she can continue to utilize TRICARE Prime benefits.
If the college your child is attending is not in a TRICARE Prime service area or in a US Family Health Plan location, he or she should use TRICARE Standard or TRICARE Extra to minimize out-of-pocket expenses. However, if your child chooses to retain his or her Prime enrollment status rather than using Standard or Extra, he or she will be subject to point of service charges for any care received without a referral from his or her primary care manager (PCM).
TRICARE Prime split enrollment offers you the option of having your college-age student enrolled in one region while the rest of your family lives and remains enrolled in another region. If you decide that split enrollment is the right option for you and your college student, here are some important points to remember:
- If you are an active duty service member, you may transfer enrollment as often as necessary.
- To be considered eligible, you must inform both regions of your family’s split enrollment status.
- Don’t forget to complete and sign an enrollment application or change request form and submit it to the appropriate contractor in the region where your son or daughter attends school. This is required if you wish to change the enrollment location.
- Enrollment fees are coordinated by the contractors. They are also responsible for sending statements to the designated payers.
- Student enrollment in TRICARE Prime is automatically renewed after one year unless the renewal offer is declined.
What should my child know before receiving care?
Once enrolled, TRICARE Prime split enrollees should always seek care from their PCM, except in the event of an emergency. If your child needs to see a specialist, make sure that he or she knows that TRICARE Prime referral and authorization rules still apply. If the beneficiary sees a provider other than his or her assigned PCM without prior authorization, the TRICARE point of service option applies, resulting in higher out-of-pocket costs.
Is my child covered while traveling?
TRICARE Prime coverage remains intact for emergencies if your child decides to travel. However, routine appointments are not covered while traveling. If an emergency occurs, have your child contact his or her PCM within 24 hours to ensure that the claim is paid properly.
For more information on split enrollment, visit TRICARE's Web Site or contact your local TRICARE Service Center or military treatment facility Beneficiary Counseling and Assistance Coordinator.
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