TRICARE Prime

The preferred health care insurance option for many military members and families is enrollment in TRICARE Prime, DOD’s Health Maintenance Organization (HMO). Under TRICARE Prime, first-time active-duty families are assigned a military primary care manager (PCM). Retirees and their families can select either a military PCM or a civilian network provider.

Primary Care Manager’s Role

The PCM serves as the medical manager for all health care needs, including preventive health care, care during illnesses and referrals to specialists when needed. Since your PCM manages your health care needs, he or she will always be the first point of contact when you need health care.

If your PCM cannot meet a specific health care need, he or she will refer you to the appropriate specialty physician. The specialist will notify your PCM of his or her findings so that your PCM can continue to manage your care. True emergency care may be an exception, and in such situations, you should go immediately to the nearest emergency room.

Other Prime Advantages

Other Advantages of TRICARE Prime Include:

• Free preventive health care benefits.
• Priority appointments to nonemergent health care.
• Lowest out-of-pocket cost shares of any of the TRICARE options.

Under TRICARE Prime, active-duty family members receive health care at no charge, while nonactive-duty family members pay a nominal fee for authorized care with a provider outside of a Military Treatment Facility (MTF). Outpatient care in the MTF is at no charge. The TRICARE Prime HMO offers the most comprehensive health care benefit, but it does have some restrictions. Please stop by one of our TRICARE Service Centers to learn more about TRICARE Prime, or call toll free 888-874-9378.