Editor’s Note: This article is part of MOAA’s 2020-21 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Mercer Consumer. A version of the guide appeared in the November 2020 issue of Military Officer magazine.
TRICARE Prime and TRICARE Prime Remote offer a big benefit for certain beneficiaries: Expenses for transportation, lodging, and meals are covered if you need to travel away from home for specialty care.
Who Is Eligible?
Travel for specialty care is reimbursable for any non-active duty beneficiary who is covered by TRICARE Prime, including active duty family members and retirees and their family members. This benefit is available within the U.S., including Alaska and Hawaii.
Patients must be referred for medically necessary, non-emergency care by their primary care manager (PCM). The provider must be located more than 100 miles, one way, from the PCM’s office, and there must be no other available provider within that 100-mile radius.
In certain situations, TRICARE may also cover the travel expenses of a family member accompanying the patient. Non-medical attendants are covered if the patient is under 18, or if the referring provider certifies, in writing, that the patient requires someone to travel with them. The non-medical companion must be a parent, spouse, legal guardian, or other family member over the age of 21.
[TRICARE GUIDE: What’s Covered, What’s Not]
While active duty servicemembers are not covered under this benefit for their own care, the travel reimbursement may also be paid to active duty members who are traveling as a non-medical caregiver for an eligible patient. There are additional steps for approval of the active duty service member as the accompanying caregiver. If this applies to you, be sure to read the written guidance and coordinate with your command and the Prime Travel Office.
How Reimbursements Work
There are three steps to use the TRICARE Prime Travel Reimbursement benefit:
1. Contact Your Prime Travel Office. Start your claim with the Prime Travel Office or your local area contact as soon as you are referred for qualifying specialty care. Your Prime Travel Office can help you figure out your benefits before you book your travel. There are a lot of specific instructions for every aspect of the reimbursement program.
If your PCM is located at a military treatment facility, that MTF should have a travel coordinator. If you have a civilian PCM, or you are a Coast Guard family, contact the Prime Travel Office at 1-844-204-9351 to initiate the process.
2. Make Your Arrangements and Travel. You will book your own travel and lodging, and may choose whatever method of travel and type of lodging. However, the Prime Travel Reimbursement program will reimburse you only for the most cost-effective options, including economy class air or train travel, compact-class rental cars, and the local government per diem rate for lodging. You will also be reimbursed for the actual cost of meals, up to the local area rate, and parking, tolls, and fuel.
You may travel via your personal vehicle, and be reimbursed at the “other mileage rate” as determined each year. For 2020, that rate is 17 cents per mile.
While traveling, keep every receipt. It’s a good idea to take a photo with your phone and upload it to your email, OneDrive, or Google Drive before filing the paper receipt.
[TRICARE GUIDE: What Happens When I Retire?]
3. File Your Travel Claim. Reimbursement is made for actual expenses, and requires dated, itemized receipts for everything except fuel. You’ll also need documentation from the medical office that shows the date and time of your appointment(s). Your local coordinator or the Prime Travel Office can help you with a checklist of the required documentation.
Claims are submitted via email or regular mail to the Prime Travel Benefit Office. The office will enter your claim into the Defense Travel System. It can take a few weeks to receive your reimbursement.
For more information about the TRICARE Prime Travel Benefit, visit this travel reimbursement page at TRICARE.mil.
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