TRICARE Prime

TRICARE Prime is a managed care option available in Prime Service AreasGeographic areas in the U.S. where we offer TRICARE Prime. They ensure medical readiness of active duty by adding to the capability and capacity of military hospitals and clinics. Prime Service Areas were also built around the Base Realignment and Closure sites..

• Check your ZIP Code to see if you live in a Prime Service Area
• Enrollment is required; some beneficiaries pay annual enrollment fees.
• Meets or exceeds the requirements for minimum essential coverageBasic health care coverage that meets the Affordable Care Act requirement. If you don’t have coverage, you may have to pay a fee for each month you aren’t covered. under the Affordable Care Act.

Additional Prime options for active duty service members and their families include:

• TRICARE Prime Remote
• TRICARE Prime Overseas
• TRICARE Prime Remote Overseas 

Who Can Participate?

• Active duty service members and their families
• Retired service members and their families*
• ActivatedCalled or ordered to active duty service for more than 30 days in a row. Guard/Reserve members and their families
• Non-activated Guard/Reserve members and their families who qualify for care under the Transitional Assistance Management Program
• Retired Guard/Reserve members at age 60 and their families*
• Survivors
• Medal of Honor recipients and their families
• Qualified former spouses

*When retired service members and their families become eligible for TRICARE For Life, they are no longer able to enroll in TRICARE Prime.

How it Works

You have an assigned primary care manager (PCM) who provides most of your care.

• Military or network provider
• Refers you to specialists for care he or she can't provide
• Works with your regional contractor for referrals/authorization
• Accepts your copayment and files claims for you

What You Pay

• Active duty service members pay nothing out-of-pocket.
• Active duty family members pay nothing unless using the point-of-service option.
• All other beneficiaries pay annual enrollment fees and network copayments.

>>View TRICARE Prime Costs

Is TRICARE Prime Right for You?

• If you're on active duty, you have to enroll in TRICARE Prime.
• All others can choose to enroll or use TRICARE Standard and Extra.
• TRICARE Prime offers fewer out-of-pocket costs than TRICARE Standard and Extra, but less freedom of choice for providers.
• If you have other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance.", TRICARE Prime might not be right for you.

How to Enroll—3 Options

1. Online via the Beneficiary Web Enrollment website
2. Call your regional contractor
   • North RegionConnecticut, Delaware, the District of Columbia, Illinois, Indiana, Iowa (Rock Island area), Kentucky (except Fort Campbell), Maine, Maryland, Massachusetts, Michigan, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin.: 1-877-874-2273
   • South RegionAlabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee, Texas (excluding El Paso area), and Fort Campbell, Kentucky: 1-800-444-5445
   • West RegionAlaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington and Wyoming.: 1-877-988-9378
3. Mail the enrollment form to your regional contractor (mailing addresses on the form):
   • North Region Form
   • South Region Form
   • West Region Form

Once you have enrolled you can download a TRICARE wallet card to take to your appointments but you must also show your military ID as proof of coverage.

>>Visit the TRICARE Prime Enrollment Page to Learn More