TRICARE Prime es una opción de atención administrada similar a una organización civil para el mantenimiento de la salud (HMO). It is available in areas around military treatment facilities (MTF) and former base realignment and closure (BRAC) sites. TRICARE Prime Remote (TPR) is available for active duty service members who live and work more than 50 miles from an MTF and their eligible family members.
Beneficiaries enrolled in TRICARE Prime have an assigned primary care manager (PCM) and may require a prior authorization and/or referral for specialty care.
Benefits, cost shares and deductibles are based upon your sponsor’s status.
Those eligible for TRICARE Prime include:
In addition, beneficiaries must be registered in the Sistema de informes de elegibilidad para inscripción de la Defensa (DEERS) and must choose a PCM where TRICARE Prime is offered.
Consulte nuestras Determining TRICARE Prime Availability page to determine if you reside in a Prime Service Area or are eligible to enroll in TPR or TRICARE Prime Remote for Active Duty Family Members (TPRADFM).
You may enroll in TRICARE Prime by:
TRICARE Prime enrollment requests for active duty service members are effective the day the application or telephone request is received by Health Net Federal Services, LLC (Health Net).
TRICARE Prime enrollment applications for active duty family members follow the 20th of the month rule, meaning applications received on or before the 20th of the month are effective the first day of the next month.
Your family member is not automatically covered by TRICARE Prime. To make sure your family member is enrolled in TRICARE Prime, you must complete two steps:
Your family member will be covered automatically under TRICARE Standard. Enrollment into TRICARE Prime will follow the 20th of the month rule.
If a family member is enrolled in TRICARE Prime or the sponsor is an active duty service member, a newborn or adoptee will be treated as a TRICARE Prime beneficiary as of the day of birth or adoption. Formal enrollment in TRICARE Prime is required within 60 days. If a TRICARE Prime request is received by Health Net within 60 days from the date of birth or adoption, the child is effective in TRICARE Prime on the first of the month following the date of birth or adoption.
To ensure your child has continuous TRICARE Prime coverage after the first 60 days, you must complete two steps:
If the TRICARE Prime enrollment request is not received within 60 days of your child’s date of birth or adoption, then his or her TRICARE Prime coverage will end on day 60. Applications received after day 60 will follow the 20th of the month rule.
A new TRICARE Prime enrollment request is required when your status changes in DEERS.
De servicio activo a retirado
See our TRICARE Prime Enrollment - Retired Service Members and Their Families Ver historial de pagos.
Active duty to Transitional Assistance Management Program (TAMP)
A TRICARE Prime enrollment request must be received while you are eligible for TAMP for TRICARE Prime enrollment to be backdated to the date TAMP eligibility started. Family members must have been enrolled with TRICARE Prime through the last day of the sponsor's active duty orders to qualify for backdated coverage. La inscripción de un patrocinador siempre es retroactiva con el TAMP, sin importar el estado de inscripción en TRICARE Prime mientras esté en servicio activo. Beneficiaries enrolled in TAMP are not eligible for TPR. See our Determining TRICARE Prime Availability Ver historial de pagos.
Separating from the military
Los beneficios finalizan el último día del servicio militar del patrocinador. Log in to the milConnect website to determine when your benefits end. You may be eligible to enroll with the Continued Health Benefits Program (CHCBP). TRICARE Reserve Select is available for select members of the National Guard and Reserve and TRICARE Retired Reserve está disponible para reservistas retirados y sus familiares.
TRICARE Reserve Select (TRS) to active duty
A TRICARE Prime enrollment request must be received within 30 days of your sponsor's active duty start date to qualify for backdated coverage. Sponsors and family members must have been enrolled with TRS the day before the sponsor's active duty start date to qualify for backdated coverage.
Surviving spouses remain eligible for TRICARE as long as they do not remarry. For the first three years following the death of their sponsor, they fall under transitional survivor status and are eligible for active duty family member TRICARE benefits and costs. After three years, spouses convert to survivor status and are eligible for TRICARE retiree benefits and costs.
Children up to the age of 21, or 23 if a full-time student, are eligible with transitional survivor status for active duty family member TRICARE benefits and costs until TRICARE eligibility ends due to age limits or another reason, such as marriage.
For information, visit TRICARE’s survivor Ver historial de pagos.
Currently enrolled TRICARE Prime or TRICARE Prime Remote beneficiaries who move to an area that offers TRICARE Prime enrollment can transfer their enrollment online, by mail, or phone. Vea Mudanzas simplificadas: transferir la inscripción en TRICARE Prime para obtener información acerca de estas opciones. Your enrollment transfer will be effective the date your request is received. Please note that if you use BWE, your transfer will be effective six days from the date you submit the request.
You may voluntarily disenroll from TRICARE Prime or TRICARE Prime Remote once per fiscal year (October 1-September 30) without a lockout. If you are disenrolling for the second time in the fiscal year, you will not be allowed to re-enroll with TRICARE Prime or TRICARE Prime Remote for 12 months. Family members with sponsors ranked E1-E4 will not be locked out. Once you disenroll from TRICARE Prime, you will be covered under TRICARE Standard.
You may disenroll:
Asegúrese de que su inscripción esté completa. Revise la lista de control de inscripción para obtener ayuda.