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Changes to Prime Service Areas

On October 1, 2013, some beneficiaries lost TRICARE Prime when the Prime Service Areas (PSAs)Geographic areas in the United States where TRICARE Prime is offered. Prime Service Areas were created to ensure medical readiness of the active duty force by augmenting the capability and capacity of military hospitals and clinics. Prime Service Areas were also built around the Base Realignment and Closure (BRAC) sites. changed. A new rule allows them to continue their TRICARE Prime enrollment.  

Am I eligible?

You’re eligible if:

  1. You were disenrolled because your Prime Service Area was eliminated
  2. You live within 100 miles of a military hospital or clinic

You’ll get a letter explaining this one-time opportunity and your next steps if you meet both conditions.

What does continued enrollment mean?

  • You’ll get a new primary care manager from a remaining Prime Service Area
  • Your enrollment is retroactive to October 1, 2013
  • Any claims processed under TRICARE Standard will be reprocessed under TRICARE Prime

What are my next steps?

To take advantage of this one-time opportunity to continue your enrollment:

  • Re-enroll in TRICARE Prime with your regional contractor.
  • Include your payment of enrollment fees back to October 1, 2013.
  • Complete Section V of the enrollment form to waive your drive-time standards.
    • Check the box
    • Complete blocks 1, 2, & 3
  • The form and payment must be received by June 30, 2014.

You should call your regional contractor first to:

  • Get help getting a new PCM
  • Confirm your enrollment fee back-payment amount
  • Re-establish your automatic payment

Things to Consider

Before you make your decision, know that:

  • You probably won’t have the same PCM that you had before.
  • You may have to drive farther to get primary and specialty care.

If you don’t want to continue your TRICARE Prime enrollment, you don’t need to take any action.  You still can use TRICARE Standard and Extra.

 

Last Updated 4/15/2014