TRICARE Prime: Key Features

TRICARE Prime is available to the following beneficiaries as long as they are shown as eligible on DEERS:

You must enroll in TRICARE Prime to participate, but there are no enrollment fees for active duty service members and their families.  Retired service members, their families, survivors, eligible former spouses, and others enrolled in TRICARE Prime are required to pay an annual enrollment fee for individuals and for families, which is applied to the catastrophic cap.  Prime has flexible enrollment options which include:

When moving to another location within your TRICARE region or to a new TRICARE region, you can easily transfer your TRICARE Prime enrollment.

There are fewer out-of-pocket costs than other TRICARE options.  Prime also has enhanced coverage for vision and clinical preventive services and priority access for care at Military Treatment Facilities (MTFs). 

Most care is received from an assigned Primary Care Manager (PCM) and your PCM is who refers you to specialists when necessary. Point of service options are available (to all but active duty service members) to receive care without requesting a referral from your PCM (resulting in higher out-of-pocket costs).  A prior authorization is required for certain types of care and must be obtained before services are rendered.  Your PCM will request prior authorization when required.  Also, in most cases, there are no claims to file.