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Active duty service members (ADSMs), including National Guard and Reserve members called to active duty for more than 30 consecutive days, must enroll in TRICARE Prime or TRICARE Prime Remote (described below)—proceed to Step 4 for information about how to enroll.
Here are some general features of the TRICARE Prime options:
- Enrollment required
- Enhanced benefits and services
- Priority access for care at MTFs
- Most care received from an assigned PCM (or approved TRICARE-authorized provider if enrolled in TPR/TPRADFM and network providers are not available)
- PCM referrals required for specialty care
- No claims to file (in most cases)
Figure 3.2 TRICARE Prime Options
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TRICARE Prime
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TRICARE Prime is a managed care option offering the most affordable and comprehensive coverage. TRICARE Prime is available in TRICARE Prime service areas (PSAs)—areas near an MTF and where regional contractors have established TRICARE Prime networks. While ADSMs must enroll in TRICARE Prime where available, ADFMs, retired service members and their family members, survivors, certain former spouses, and other eligible beneficiaries may choose to enroll in TRICARE Prime or remain covered by TRICARE Standard and TRICARE Extra. |
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TRICARE Prime Remote (TPR)
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TPR offers a TRICARE Prime benefit for ADSMs who live and work more than 50 miles or an hour’s drive from an MTF. Visit the TPR Web site and type in your residential and work ZIP codes or call Humana Military to determine your eligibility.
If you live or work within 50 miles of an MTF, you will generally not be eligible for TPR. However, you may submit a TPR Determination of Eligibility Enrollment Request form if you believe geographic boundaries cause you to drive more than one hour to an MTF. The request must be directed through your unit commander to the TRICARE Regional Office (TRO) in your area. Visit the TPR Web site to submit your request online. |
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TRICARE Prime Remote for Active Duty Family Members (TPRADFM)
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TPRADFM is available to eligible ADFMs residing with their TPR-enrolled sponsors. Your DEERS address information is used to determine residency, and accurate address information in DEERS is essential to determine your eligibility for TPRADFM. In most cases, you can remain enrolled in TPRADFM if your sponsor received unaccompanied orders to another location, if you don’t move from the TPR ZIP code location where you are enrolled. |
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