TRICARE Prime Remote (TPR) is a program that provides active duty beneficiaries in the United States with the TRICARE Prime option while they are assigned to duty stations in areas not served by the traditional Military Health System. TPR is currently available only to active duty service members; however, recent legislation has extended the TPR benefit to active duty family members residing with their TPR-eligible active duty sponsors in remote locations. TRICARE Prime Remote for active duty family members (TPRADFM) is expected to begin September 2002.
Eligibility for TRICARE Prime Remote
- Active duty personnel, under full-time orders, who live and work more than 50 miles or one hour's drive time from a military treatment facility, in TPR-designated ZIP codes, must enroll in TPR. In some cases, where geographic boundaries create undue hardship for travel, members living closer than 50 miles may be eligible for TPR. Beneficiaries may check their eligibility on the TPR Web site at www.tricare.osd.mil/remote.
- Beginning in September 2002, active duty family members residing with their TPR-eligible sponsors will become eligible for TPRADFM.
- Reserve component family members must meet the eligibility requirements for TRICARE Prime (sponsor must be called to active duty for 179 days or more) to be eligible for TPRADFM.
Interim "Waived Charges" Benefit Ending
The interim "waived charges" benefit that began in August 2001 will end in September 2002 when TPRADFM is implemented. The "waived charges" benefit is for TPRADFM-eligible active duty family members residing with their TPR-eligible active duty sponsor in TPR areas. This benefit, implemented on August 1, 2001, waived most cost shares, co-pays, and deductibles associated with health care claims from October 30, 2000. Active duty family members choosing not to enroll in TPRADFM will use TRICARE Standard or Extra with applicable cost shares and deductibles. Active duty service members are not eligible for the "waived charges" benefit, as they do not incur co-pays, cost shares, or deductibles.
Obtaining Medical Care with TRICARE Prime Remote
TPR enrollees, and TPRADFM enrollees (once TPRADFM is implemented), may select or be assigned a local primary care manager (PCM) when network primary care providers are available within the TRICARE Prime drive-time access standards. PCMs provide preventive services, care for routine illnesses or injuries, and manage referrals to specialists or hospitals if needed. If more than one network primary care provider is available, beneficiaries may choose the provider they prefer. If no network primary care providers are available, beneficiaries may use any TRICARE authorized provider for primary care. Beneficiaries may contact their TRICARE regional managed care support contractor (MCSC) to locate TRICARE authorized providers.
If a PCM determines specialty care is needed, that care must be coordinated through the regional health care finder (HCF) located with the TRICARE regional MCSC. Network PCMs will coordinate specialty care with the regional HCF. However, beneficiaries who do not have a network PCM will need to coordinate their specialty care with the regional HCF. The regional HCF will coordinate active duty TPR specialty care referrals through the service point of contact (SPOC) to determine if the specialty care must be received from a military provider for a "Fitness for Duty" determination. Specialty care referrals for TPR active duty family members are managed by the HCF and are not coordinated through the SPOC.
Active Duty Service Members' Service Points of Contact (SPOC)
The SPOC for the Army, Navy, Air Force, Coast Guard, and Marine Corps are based at the Military Medical Support Office (MMSO) at Great Lakes, Illinois. Active duty service members with questions for the SPOC, may call MMSO Customer Service at 1-888-MHS-MMSO (1-888-647-6676). Written inquiries should be addressed to the appropriate address listed on MMSO Web site http://mmso.med.navy.mil/MMSO_Address_Contact_Info.html. General questions may be addressed to:
Military Medical Support Office (MMSO)
PO Box 886999
Great Lakes, IL 60088-6999
Dental Care with TRICARE Prime Remote
Active duty service members, except Coast Guard, are covered under the Tri-Service Remote Dental Program (RDP). There is no preferred dental network, so care can be received from any licensed dentist in the area. Active duty service members, except Coast Guard, may contact their SPOC directly for information and authorizations related to dental treatment. More information about the RDP can be found at the MMSO Dental Web site at http://mmso.med.navy.mil/MMSO_Dental_Info.html or by calling MMSO customer service at 1-888-MHS-MMSO (1-888-647-6676). Coast Guard service members may call 1-800-942-2422 for information and authorizations related to dental treatment. Family members are covered under the TRICARE Dental Program (TDP).
For More Information
For more information about TRICARE Prime Remote, TRICARE Prime Remote for active duty family members, or the interim "waived charges" benefit, beneficiaries may contact their TRICARE regional MCSC or visit the TRICARE Prime Remote Web site.
More about TPRADFM
page last modified on: 5/7/2013