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Benefits of Tricare Prime

Benefits of Tricare Prime

Read on to find out how the most basic health care plan that TRICARE has to offer works. With all basic medical services covered and almost zero out-of-pocket costs, this is a popular plan amongst beneficiaries.

TRICARE Prime health care plan

The TRICARE Prime health care plan is available in certain areas across the United States; in order to find out whether it caters to a certain region or not, you can simply check online by using your ZIP code. The TRICARE Prime health care plan is known for being the most easily affordable health care plan, which also provides all the minimum essential benefits that need to be provided to any individual according to the Affordable Care Act.

As soon as someone is enrolled into the TRICARE Prime health care plan, a primary care manager is assigned to him or her. This primary care manager can be chosen by the person himself or herself; this means you have the advantage of choosing a military provider or a network provider. In case you cannot do this for yourself, TRICARE can do it for you. The main benefit of having this primary care manager is that this provider will be solely responsible for managing all your health care needs. This means that you do not even need to call a doctor in order to make an appointment for yourself if the need ever arises, because the primary care manager will do it for you.

In addition to this, the primary care manager will also maintain a health record for each beneficiary assigned. Furthermore, in case you ever have to pay up front to a non-network provider, you will not have to worry about filing claims for the reimbursement because this will also be done by the primary care provider. In essence, this relieves you from a lot of hassle and paperwork.

Most of your basic and primary health care needs will be catered for by the primary care manager. However, in case the situation is such that you need to consult a specialist doctor, the primary care manager will also provide you with a referral to the specialist you need to see, as well as provide authorization for any additional services that you may require. Thus, this makes the TRICARE Prime plan a very comprehensive plan, which provides all users with a great deal of convenience.

What makes this plan extremely cost effective is that there is very little that you will have to pay out of your own pocket. If you are currently serving in the military forces, you will not even have to pay any enrollment fee. Your family members will not have to pay anything out of their own pockets either, until and unless they make use of a point-of-service option.

With all basic benefits being covered by the TRICARE Prime health care plan for almost zero payments out of your own pocket, many users are simply willing to overlook the fact that there is little choice available as far as providers of health care services are concerned. This is also because TRICARE is a system that has integrated the best health facilities of all the uniformed forces, which makes for a strong and easily accessible system.

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32 comments

  1. I am enrolled in Tricare. I don’t know if I have Prime but I think I do. How do I get my wife into Prime also? I am on active duty orders and I would like to enroll her as soon as possible. I have updated my DEERS and she is in the system. What do I do??

  2. Hi; My husband is retired Navy and he just recently read an email about the ER and Urgent Care facilities and the NAL…I have searched this website for the explanation of the above but cannot seem to find it. Would someone please explain what is happening with both of those situations…It has been that if taken to an ER or an Urgent Care Clinic, we needed to notify our PCM within 24 hours of doing so….only went to ER or clinics if naval clinic was not open, week nights and weekends, but have heard that has changed. I have done the above for over 25 years now and would like to know the new way of doing this.

    Thank you and look forward to hearing from someone,

    Charlene Thompson:)

  3. Respectfully request information on Tricare prime

  4. I need a telephone for providers for Tricae Prime Active Duty please.

  5. My husband is AD and we have Tricare Prime. I have heard that Tricare now covers breast pumps. I was just needing to know if this is accurate and, if so, how do we go about receiving a pump?

  6. I Faxed in my application to enroll in Tricare Prime a few weeks ago, yet I have had no response or confirmation that I am enrolled. I did not name a provider as I thought I would select one once enrolled. Please advise me as to whether or not I am now enrolled in Prime. If so, I will select a provider and furnish their name. If not, please let me know how to go about re-enrolling. The VA has denied my claims saying that I need a civilian provider to provide them with evidence of my medical problems. I’m currently on TRICARE Standard, but wish to enroll in Prime as it is a better plan. Most providers will not accept TRICARE Standard. Thank you.

  7. I am trying to get some information about Tricare for a form for my doctor’s office. I need address, telephone, Ppo or not.

  8. I am thinking of dropping the med gap insurance I have as it is getting to expensive for me. Will Tiricare cover me as I am not close to any military bases? I have been using my Tricare Prime for my meds.

    Sincerely,

    Lesley Fowlow

  9. does tricare cover opthamology for family

  10. I’m in Pensacola Florida, where I retired in 91, but I’m moving to Clinton MO. how do I switch between areas, our family Doctor up there already has other retired going to her. But I have to switch , I guess, to a central system of something?

  11. Want more information point contact phone number

  12. Does Tri Care Prime have the silver sneakers benfit for older vets and spouse to join a gym. We are both over the age of 65 and on medicare part a and b

  13. Hello.
    I can’t find section for new enrollment.
    My husband is a deceased retiree and we had Prime coverage.
    Before he passed away…someone somehow wiped us out of coverage and DEERS.
    It was a mess…but we got that fixed. Even though letters than stated we didn’t have coverage after he passed away. So sad that the good people have to take hours/days/weeks to fix when it took a second for someone to change his days of retirement in the system by 10 days….but he had been retired for 13 years when this occurred. No one ever told me what happened and by who.

    Then months later the SocSec dept or Treasury dept started his SocSec benefits.
    Which I knew I wasn’t entitled to. Then my checking acct was locked up for 3 weeks trying to fix this.
    And somehow in that mess apparently myself & my daughter were again dropped off Prime.

    I just need to know where to go as folks from Mtn Home AFB, ID are telling me that my daughter & I are still eligible for Prime. And of course, I know I need to pay for the coverage quarterly…which I was doing till issues with bank, etc. And I never got a letter that we were dropped.

    Appreciate your help.
    Jean

  14. There is no place to enter your zip code to see if Tricare Prime is available in my area as the article states. Where do I go

  15. I’m a vet my spouse will need in home care will tricare pay for it

  16. How do I obtain a copy of a medical record from archived files? It was referred through a MTF but completed at a civilian clinic.

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