What is the TRICARE Prime Demo program?
Quick Answer
TRICARE Prime Demo is a 2026 pilot program in Atlanta and Tampa managed by CareSource. It removes referral requirements for specialty care, waives enrollment fees, and offers enhanced benefits to test improvements to TRICARE Prime.
Key Takeaways
- Pilot program in Atlanta and Tampa for 2026
- No referrals needed for specialty care
- Enrollment fees are waived for participants
- Managed by CareSource, a nonprofit health plan
Detailed Answer
TRICARE Prime Demo is a new demonstration program designed to test improvements to the traditional TRICARE Prime managed care model. It launched as a pilot in select markets for calendar year 2026.
Program Overview
- Pilot markets: Atlanta, GA and Tampa, FL metropolitan areas
- Managed by CareSource, a nonprofit health plan
- Available to eligible beneficiaries in the pilot areas
- Designed to test a more flexible version of TRICARE Prime
Key Benefits of Prime Demo
- No referrals required for specialty care (unlike traditional Prime)
- Enrollment fees waived for participating beneficiaries
- Enhanced care coordination and case management
- Access to CareSource provider network
- Streamlined appointment scheduling and care navigation
Who Can Enroll
- Active duty family members in pilot areas
- Retirees and their families in pilot areas
- Must live within the Atlanta or Tampa Prime Demo service area
- Current TRICARE Prime and Select beneficiaries can switch during enrollment periods
How It Differs from Traditional Prime
- Traditional Prime requires PCM referrals for specialists; Prime Demo does not
- Traditional Prime has enrollment fees for retirees; Prime Demo waives them
- Prime Demo offers dedicated care coordinators
- Enhanced digital health tools and telehealth access
Important Considerations
- This is a limited pilot program and may not be available in all ZIP codes within the metro areas
- The program is being evaluated for potential expansion to other regions
- Beneficiaries can switch back to traditional Prime or Select during Open Season
- Coverage benefits are similar to TRICARE Prime with added flexibility
How to Enroll
- Check eligibility based on your ZIP code
- Contact CareSource directly or your TRICARE regional contractor
- Enroll during Open Season or a qualifying life event
Helpful Tips
- Check if your ZIP code falls within the Prime Demo service area before trying to enroll
- Compare Prime Demo benefits against your current plan before switching
- Keep in mind this is a pilot that may change or expand in future years
Related TRICARE Terms
Related Questions
What is the difference between TRICARE Prime and TRICARE Select?
TRICARE Prime is a managed care option with a primary care manager and lower costs. TRICARE Select offers more flexibility to choose providers with higher out-of-pocket expenses.
How do I switch between TRICARE Prime and Select?
You can switch plans during the annual Open Season (Nov-Dec) or after a Qualifying Life Event like PCS, birth, or marriage.
Do I have to pay TRICARE Prime enrollment fees?
Active duty families pay no Prime enrollment fees. Retirees pay annual enrollment fees starting at $179 for individual or $358 for family in 2024.