TRICARE Prime

TRICARE Prime is a managed care option where an assigned primary care manager handles most of your care and refers you to specialists.

Applies to: TRICARE Prime · All regions

TRICARE Prime is a managed care option available in Prime Service Areas. You get an assigned primary care manager (PCM) who provides most of your care and refers you to specialists for care they cannot provide.

Who can use it

TRICARE’s page lists active duty service members and their families, survivors, and other eligible groups. If you are on active duty you must enroll in TRICARE Prime. Other beneficiaries can choose Prime or TRICARE Select. Retirees lose eligibility once they become Medicare-eligible because of age, and move to TRICARE For Life.

How it works

• Your PCM can be a military provider or a civilian network provider. The PCM works with your regional contractor on referrals and authorizations. See how to choose or change your PCM.
• Referrals: specialist care generally goes through your PCM first. Do I need a referral with TRICARE Prime? explains the details.
• Enrollment is required. TRICARE says some beneficiaries pay annual enrollment fees; active duty service members pay nothing out of pocket. TRICARE’s Prime cost pages list the current amounts, so check them there instead of relying on a number copied from a website.
• Where it is offered: Prime Service Areas. Use TRICARE’s Plan Finder to see whether your address is in one.

Related Prime options

TRICARE also offers TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas, the US Family Health Plan (offered in six areas of the U.S.), and the TRICARE Prime Demo (Atlanta, Georgia and Tampa, Florida).

Changing plans

You normally change plans during Open Season or after a qualifying life event. To leave Prime, see TRICARE’s disenrolling page.