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The TRICARE Prime program is TRICARE's version of a Health Maintenance Organization (HMO). When you enroll in Prime, you choose a Primary Care Manager (PCM) who is your primary doctor for as long as you are enrolled in the program. Of course, you may change your PCM if you wish. Just contact a Beneficiary Service Representative (BSR) at your TRICARE Service Center (TSC).
TRICARE Prime offers several benefits:
No annual deductible.
A broad range of wellness benefits including routine exams, immunizations and preventive services — all with no copayment.
A Primary Care Manager (PCM) you select from a network. Your PCM coordinates all of your healthcare. If you have a specific health problem that your PCM does not handle, he or she will refer you to another doctor who specializes in that field. For example, if you have a heart condition, your PCM may refer you to a cardiologist.
A Point-of-Service (POS) option that allows you to seek medical services without going through your PCM.
A network of providers who agree to provide services at a reduced rate — a significant savings for you.
Military retirees and their dependents pay an annual enrollment fee. Active duty family members enroll for free.
Copayments are listed in the TRICARE Handbook, so there are no surprising out-of-pocket costs.