Primary Care Manager
PCM
Quick Definition
Your main doctor who coordinates your healthcare.
Video Explanation
Full Definition
A Primary Care Manager (PCM) is the main doctor or healthcare provider who manages your overall healthcare and coordinates specialty care. PCMs are required for TRICARE Prime beneficiaries and serve as the central point for all non-emergency medical needs.
PCM responsibilities: • Provide routine and preventive care • Diagnose and treat common illnesses • Manage chronic conditions • Issue referrals to specialists when needed • Coordinate care between providers • Maintain your medical records • Order necessary tests and screenings
Who needs a PCM: • Required: All TRICARE Prime enrollees • Optional: TRICARE Select beneficiaries • Not required: Active duty (though they have assigned providers)
Your PCM can be: • A military provider at an MTF • A civilian network provider • A group practice • A physician assistant or nurse practitioner (in some cases)
Changing your PCM: • TRICARE Prime: Can change annually or for cause • Contact your regional contractor • May need to wait for processing period
Benefits of having a PCM: • Continuity of care with one provider • Better coordination of healthcare needs • Someone familiar with your medical history • Single point of contact for health concerns
TRICARE Prime's PCM model ensures coordinated, comprehensive care while controlling costs through the referral system.
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 find a TRICARE provider?
Use the online provider directory on your regional contractor's website or call them directly for assistance.
How does TRICARE work when stationed overseas?
TRICARE Overseas Program (TOP) provides coverage for service members and families stationed outside the US through military facilities and civilian providers.
Does TRICARE cover mental health services?
Yes, TRICARE covers mental health services including therapy, counseling, and psychiatric care with the same cost-shares as medical services.
How does TRICARE cover pregnancy and maternity care?
TRICARE covers comprehensive maternity care including prenatal visits, delivery, postpartum care, and newborn care at no or low cost.
How does TRICARE cover emergency room visits and urgent care?
TRICARE covers emergency care worldwide without prior authorization. Visit nearest ER for emergencies; urgent care for non-emergencies.
What preventive care services does TRICARE cover?
TRICARE covers comprehensive preventive care at no cost including annual checkups, vaccines, cancer screenings, and wellness visits.
What's the difference between a referral and prior authorization?
Referrals allow you to see specialists (Prime requirement). Prior authorization is approval needed before certain services regardless of plan.
How does TRICARE cover autism spectrum disorder?
TRICARE covers autism diagnosis, ABA therapy, speech therapy, occupational therapy, and medication through the Comprehensive Autism Care Demonstration.
What is TRICARE Prime Remote?
TRICARE Prime Remote provides Prime-level benefits to active duty members and families living 50+ miles from an MTF with no enrollment fee.
What is a Primary Care Manager (PCM)?
A PCM is your main doctor in TRICARE Prime who provides routine care, manages your health, and issues referrals for specialty care.
What is TRICARE Prime Overseas?
TRICARE Prime Overseas provides managed care for families living overseas with a primary care manager at an MTF or network provider.
Related Terms
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