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.
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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.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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