Are you moving to a new home? Is it more than a 30-minute drive from your primary care manager? If so, TRICARE is making it simpler to keep your TRICARE Prime coverage. Now, most families who live more than 30 minutes but less than 100 miles from their PCM can continue seeing them without taking action.
What's new?
In the past, if you moved more than 30 minutes from your PCM, you would’ve had to fill out a drive time waiver to keep your coverage. Without this form, you would’ve risked losing access to your preferred PCM.
The new policy “flips” this process. If you live more than 30 minutes but less than 100 miles from your PCM, you won’t need to take any action to keep your coverage. TRICARE will automatically apply the drive time waiver for you, making it easier to keep your current PCM.
“Our data shows more than half of beneficiaries who waived their drive time access to care standard due to address issues lived less than 100 miles from their military hospital or clinic,” said Shane Pham, management and program analyst, TRICARE Health Plan Policy & Programs Branch, at the Defense Health Agency. “This new approach will help prevent unnecessary coverage gaps and ensure families keep access to their PCMs.”
How will it work?
If your TRICARE regional contractor learns that you’ve moved more than 30 minutes from your PCM, based on information on file, they’ll:
- Call you
- Send you a text
- Mail you a letter
- Email you
They’ll contact all adults in your household. You’ll have 90 days from the notification date to decide what to do about your coverage.
What do you need to do?
Your next steps depend on how far you live from your PCM.
If you live more than 30 minutes, but less than 100 miles, away:
- You don't need to do anything if you want to keep TRICARE Prime coverage. Your coverage will stay the same, and you’ll keep your same PCM.
- You can switch health plans if you want to.
If you live more than 100 miles away, you must choose one of these options within 90 days being notified by your regional contractor:
Switching to TRICARE Select or the USFHP (where available) lets you choose your PCM regardless of distance from your home. TRICARE Select lets you manage your own health care and get care from any TRICARE-authorized provider without a referral (in most situations), as described in the TRICARE Choices in the United States Handbook.
If you live more than 100 miles away and don't choose one of these options within 90 days, you'll be disenrolled from TRICARE Prime and lose access to your PCM. You could then only get care at military hospitals and clinics if space is available. You’d need to wait until the next TRICARE Open Season to enroll in a plan.
Remember: Moving is a Qualifying Life Event. A QLE allows you and your eligible family members to change your TRICARE health plan outside of TRICARE Open Season. But if you don’t make a change within 90 days, you’ll need to wait until the next open season to enroll in a plan.
Update your information in DEERS
Are you planning to move soon? When you do, make sure to update your address in the Defense Enrollment Eligibility Reporting System. Check that your email address and phone number are current, too. This will help make sure you don’t miss any important communications from TRICARE, including messages about drive time waivers.
You can update your information:
Need help?
If you have questions, call your regional contractor:
This new process gives you time to make decisions about your care. You'll have 90 days from the date your contractor notified you to look at your options and choose what works best for your family. If you’re thinking of switching or enrolling in a new TRICARE health plan, check out the TRICARE Plan Finder tool.
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