April 18, 2014
More than 170,000 TRICARE Prime beneficiaries were forced out of Prime and into TRICARE Standard on October 1, 2013 as a result of changes made in the most recent round of TRICARE contracts.
The contracts reduced Prime Service Areas to within 40 miles of a military hospital, clinic, or base closure site.
The FY 2014 Defense Authorization Act grandfathered many of those affected by the reduction in Prime Service Areas. Specifically, it offered coverage to former Prime beneficiaries if they:
- Live in a ZIP code that was a Prime Service Area as of Sept. 30, 2013; and
- Live within 100 miles of a military medical treatment facility
Roughly 76,000 beneficiaries meet the requirements to be “grandfathered” into TRICARE Prime and are eligible to re-enroll if they choose.
TRICARE officials announced the long awaited re-enrollment procedures this week.
On April 28, TRICARE will mail instructions to affected beneficiaries. They have until June 30th to re-enroll in the program.
To re-enroll, the beneficiary must submit an enrollment form, waive the drive time standards, and choose a Primary Care Manager (PCM) inside an existing Prime Service Area. The TRICARE contractors in your region will help you find an available PCM. Enrollment forms will be available at www.tricare.mil/forms/.
Eligible beneficiaries will be re-enrolled retroactively effective October 1, 2013, and are responsible for paying enrollment fees. Any claims processed during the retroactive period will be reprocessed as TRICARE Prime claims.