TRICARE Prime
In this option, most health care will come from a military treatment facility (MTF), augmented by the TRICARE contractor?s Preferred Provider Network (PPN). All active duty service members will be enrolled in TRICARE Prime and will continue to receive most of their care from military medical personnel. For active duty families, there is no enrollment fee for TRICARE Prime, but they must complete an enrollment form.Your Primary Care Manager (or team of providers) will see you first for your health care needs. The Primary Care Manager:
- Provides and/or coordinates your care
- Maintains your health records
- Refers you to specialists, if necessary. (To be covered, specialty care must be arranged and approved by your Primary Care Manager.)
Who is Eligible for TRICARE Prime?
All active duty personnel are enrolled in TRICARE Prime. There is no enrollment fee, but you do have to register yourself. The following people may also enroll:- Family members and survivors of active duty personnel
- Retirees and their family members, and survivors under age 65
- No enrollment fee for active duty and families
- Small fee per visit to civilian providers, and no fee for active duty members
- No balance billing
- Guaranteed appointments (access standards)
- Primary care manager supervises and coordinates care
- Away-from-home emergency coverage
- Point-of-Service option
- Reduced catastrophic cap for retirees ($7,500 now decreased to $3,000).
- Enrollment fee for retirees and their families
- Provider choice limited
- Specialty care by referral only
- Not universally available
