Dr. Sue Bailey, assistant secretary of defense for Health Affairs, announced today that thousands of active duty servicemembers who live in the United States but far from military hospitals and clinics can immediately enroll in a new program, known as TRICARE Prime Remote.
TRICARE Prime Remote facilitates access to primary medical care in the local areas where servicemembers live and work. Active duty personnel who live and work more than 50 miles from a military hospital or clinic must enroll in TRICARE Prime Remote. In areas where there are TRICARE network providers, servicemembers can select a primary care provider from the network as their Primary Care Manager (PCM). If there are no network providers, servicemembers may select any local, TRICARE-certified provider. Servicemembers will no longer need to call the nearest military hospital or clinic in order to schedule an appointment for primary care services.
"Our approach in designing the Prime Remote benefit is to focus on the needs of the servicemembers and their commanders," says Bailey. "We understand that duty in a remote area brings its own hardships. So when our servicemembers are sick, we want them to see their doctors without the hassle of long-distance phone calls or requirements to travel unreasonable distances."
"When specialty care is needed, either the primary care doctor or service member must call and get an authorization," continued Bailey. "Additionally, there will be instances when we will need to determine if the medical condition will impact a member's fitness for duty." Authorization for specialty care is obtained from the regional contractor.
"I want to stress, however, that in the event of an emergency, servicemembers should seek medical care immediately," Bailey emphasized. In these cases, pre-authorization is not required, but authorization must be obtained within 24 hours following the emergency.
The most important action that servicemembers must take is to enroll in the program. Units will be receiving enrollment packets that include an enrollment form for each assigned member. In the event a unit or service member does not receive an enrollment packet, the service member or commander should call the regional contractor to get enrollment forms and other information on TRICARE Prime Remote. These toll-free phone numbers are listed at the end of this release.
If servicemembers live in remote areas and have not yet enrolled, they still have their medical benefits. When they need non-emergency medical care, they should call the regional contractor at the number below to get an authorization. The regional contractor will also ensure the service member receives an enrollment form and other information on TRICARE Prime Remote.
Under TRICARE Prime Remote, pharmacy and mental health services are covered benefits. Pre-authorization for mental health care is required and may be obtained by calling the toll-free contractor number. Services such as toll-free health care information lines, access to preferred provider networks, utilization of regional Health Care Finders are all services available to military members in remote areas. The same TRICARE contractors that handle family member claims will now handle medical claims processing services for all active duty servicemembers.
TRICARE Prime Remote includes dental care benefits. Servicemembers in remote areas may obtain care from any licensed dentist (or VA facility where dental care is available to servicemembers). Specialty dental care, like medical care, must be approved before treatment. However, unlike medical care, the Military Medical Support Office (MMSO), Great Lakes Naval Station, Ill., will approve dental specialty care. The MMSO will also process and pay all military claims for dental care.
DoD established the MMSO, a joint service office, as part of the TRICARE Prime Remote initiative. The Navy serves as executive agent with medical representatives from the Army, Navy, Air Force and Coast Guard on the staff. The MMSO, like the regional contractors, provides 24-hour, 7-day a week service to military members who have questions about obtaining civilian health care or who experience an emergency hospitalization. The MMSO will help guide callers to the appropriate regional contractor. The MMSO can be reached at 1-888-MHS-MMSO (1-888-647-6676) or at their website, http://navymedicine.med.navy.mil/mmso/ .
At this time, family members are not eligible for TRICARE Prime Remote. However, there are some programs for family members in remote areas in Regions 1 (Northeast), 2 (Mid-Atlantic), 5 (Heartland) and 11 (Northwest). The Department is studying various options for expanding family member choices in the coming year. In the meantime, family members continue to have TRICARE Standard, and they may use TRICARE Extra in areas where network providers are available.
Personnel serving in remote areas overseas will continue to be served by the TRICARE Overseas Lead Agents (Europe, Pacific, and Latin America) in the same manner as previously arranged for remote units.
Additional information about TRICARE Prime Remote can be obtained by calling the following toll-free numbers, or by visiting the TRICARE Prime Remote website: http://www.tricare.osd.mil/remote .
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Northeast (Region 1) |
1-888-999-5195 |
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Mid-Atlantic (Region 2) |
1-800-931-9501 |
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Southeast (Region 3) |
1-877-249-9179 |
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Gulfsouth (Region 4) |
1-877-249-9179 |
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Heartland (Region 5) |
1-800-941-4501 |
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Southwest (Region 6) |
1-800-406-2832 |
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Central (Regions 7/8) |
1-877-554-2224 |
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Southern California (Region 9) and Golden Gate (Region 10) |
1-800-242-6788 |
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Northwest (Region 11) |
1-800-404-2042 |
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Pacific (Region 12), Alaska and Hawaii |
1-800-242-6788; |
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