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TRICARE Prime Travel Benefit

**FOR TRAVELERS EMPLOYED BY THE DEPARTMENT OF DEFENSE (DoD), THE TRICARE REGIONAL OFFICE - WEST (TRO-WEST) WILL ENTER TRAVEL ORDERS / VOUCHERS INTO THE DEFENSE TRAVEL SYSTEM ON THE TRAVELER'S BEHALF.**

Thank you for your interest in the Prime Travel Benefit. The following is the latest information regarding the TRICARE Prime Travel Benefit. Please make sure you print the Confirmation of Specialty Care Form, and take it with you to your appointment for the specialty care provider to complete. Please note that you must submit all documents after the trip.

STEP ONE - QUALIFYING FOR THE TRICARE PRIME TRAVEL BENEFIT
If the patient meets all of the following requirements, proceed to STEPS TWO and THREE. If not, the patient does not qualify for the benefit. In addition, specialty care received under the point-of-service (POS) option does not qualify for the benefit.

  1. The patient must be a non-active duty member or a medal-of-honor veteran enrolled in TRICARE Prime or Prime Remote with a civilian network primary care manager (PCM).

  2. The patient must have a referral from the patient's PCM to a specialty care provider (SCP) for medically necessary, NON-EMERGENCY specialty care. The referral must be authorized by UnitedHealthcare and can be reached at 1-877-988-WEST (1-877-988-9378) or www.uhcmilitarywest.com. However, if the appointment is at an MTF, a referral authorization from UnitedHealthcare will not be required. Instead, a copy of the PCM’s referral letter and the patient's Composite Health Care System (CHCS) Appointment Schedule will satisfy the requirement for verification of the PCM referral and appointment completion.

    If enrolled at a military treatment facility (MTF), contact a beneficiary counseling and assistance coordinator at the MTF to determine eligibility for the benefit or for assistance

  3. The distance from the PCM's office to the specialty care provider's office must be more than 100 miles, one way. The distance is determined zip code to zip code utilizing the Defense Table of Official Distances.

    Family members located overseas who have an active duty sponsor or who have been authorized care through the Secretarial Process, have an existing travel benefit under JFTR U5240-C so the Prime Travel Benefit does not apply.

  4. In accordance with the Joint Federal Travel Regulations, travel reimbursement claims for travel occurring on or after 26 April 2012, must be filed no later than one year after the qualifying travel date. Travel expenses will not be authorized for elective procedures or non-covered benefits.

  5. COAST GUARD Beneficiaries: For travel on and after 1 Nov 11, Coast Guard beneficiaries entitled to the Prime Travel Benefit (enrolled to MTF or network) shall contact the Coast Guard Health Safety Work-Life (HSWL) Service Center Health Benefits Team for administrative processing of their travel. HSWL Service Center Health Benefits Team is available by contacting 1-800-9HBAHBA (1-800-942-2422) or via the following address:
    Commanding Officer HSWL SERVCEN
    ATTN: Health Benefits
    300 E. Main St, Suite 1000
    Norfolk, VA 23510

STEP TWO - MAKING YOUR OWN TRAVEL ARRANGEMENTS
Reimbursement of travel expenses requires that invoices or receipts must be in the name of authorized claimants, must show valid inclusive dates, billing itemization (e.g. room rate per day), and payment in full (zero balance) with corresponding form of payment. Receipts are required regardless of amount for the following items:
  1. Air or Rail Travel: Reimbursement is limited to "economy" class unless coordinated with TRO-West.

  2. Car Rental: Reimbursement is limited to "compact" class unless coordinated with TRO-West.

  3. Lodging: Reimbursement may not exceed the local per diem rate for lodging.

  4. Fuel Reimbursement: Actual fuel expense that is incurred to transport the authorized traveler(s) from the patient's home of record (site of origin), to the referred specialty care provider's location (destination site), and back, may be eligible for reimbursement. Fuel will not be reimbursed for any dates outside the approved timeframe. Travel in-and-around the destination should be limited to the minimum necessary to satisfy the medical needs of the trip.

    Fuel receipt requirements (all supporting receipts must be provided):
    • On the day travel begins: Fill the gas tank before leaving the site of origin (regardless of the amount of gas currently in the tank). The amount of this receipt is not reimbursable since no authorized travel has yet begun. This receipt will establish a common starting point, and it will enable proper calculation of the actual fuel expense incurred during the authorized portion of the trip.
    • During the trip: Add gas as needed.
    • Immediately upon return to the site of origin: Refill the gas tank (regardless of the amount of gas currently in the tank). This receipt will establish a common endpoint to the fuel consumed during the trip.

    IMPORTANT NOTE: Fuel consumed within the authorized dates of travel, after the pre-departure fill-up, and inclusive of the final-return fill-up, is eligible for reimbursement. Legible receipts are required for reimbursement of any claimed travel expenses.

STEP THREE - SUBMITTING THE REQUIRED DOCUMENTS FOR EVALUATION AND REIMBURSEMENT UPON COMPLETION OF TRAVEL
For each eligible Prime Travel or medical appointment, the following documents must be submitted via mail, fax, or secured e-Mail. To protect personal information, transmission of documents via e-Mail is discouraged.
  1. Prime Travel Benefit Reimbursement Request Form


  2. Electronic Fund Transfer (EFT) Authorization Form: Following the initial authorized trip, it is not necessary to resubmit another EFT form for subsequent trips unless there is a change to the preferred, reimbursement bank account.


  3. PCM’s Referral and/or UnitedHealthcare Referral Authorization Letter: If the appointment is at an MTF, a copy of the PCM’s referral letter and the patient's CHCS Appointment Schedule will be required in place of the UnitedHealthcare referral authorization letter.


  4. Non-Medical Attendant (NMA) Letter: If applicable, a letter from the patient's PCM recommending that an NMA is appropriate and medically necessary to travel with an adult patient, 18 years of age or older. Without this recommendation, the NMA will not be eligible for travel expense reimbursement. Federal regulations authorize only one NMA. The NMA must be a parent, guardian, or an adult member of the patient's family who is at least 21 years of age. This requirement is waived when the patient is a minor, less than 18 years of age.


  5. Confirmation of Specialty Care Form: For verification and audit purposes, please complete this form and have it verified/signed by the specialty care provider's office, when attending appointments.


  6. ADSM or Government-Employed (GE) NMA Memorandum: Must be completed by command or appropriate agency official to authorize TDY travel reimbursement for the NMA.


  7. Travel Vouchers: DD Forms 1351-2 and 1351-3 for reimbursement of expenses claimed by the patient and/or civilian NMA. ADSM/GE NMAs are eligible for mileage and per diem allowances and need only submit DD Form 1351-2 with the supporting receipts - Filing of the DD Form 1351-3 is not required for these specific NMA categories.

            >>View Travel Voucher Instructions
            >>View Travel Voucher Checklist

  8. Original or legible receipts are required to support any expenses for which reimbursement is claimed on the Travel Voucher form(s).


  9. Prime Travel Benefit (PTB) Checklist. This form should be completed and signed to acknowledge that submitting an incomplete packet, may result in reimbursement being delayed/not processed. All documents on the checklist must completed and included in the packet submission for reimbursement.
Submitted travel claims are processed using the Defense Travel System.
  • Receipts supporting all reasonable travel expenses submitted for reimbursement must be included with each claim.


  • Government rates are used to estimate the reasonable cost.


  • Beneficiaries are expected to use the least costly mode of transportation.


  • The actual costs of lodging (including taxes) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.
The TRICARE Prime Travel Benefit is administered by TRO-West for qualified members residing in the following 21 states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (Far Western Portion), Utah, Washington, & Wyoming.

FOR MORE INFORMATION/SUBMIT PACKETS
Contact the TRO-West Travel Benefit Office via phone or e-mail: Submit your complete packet(s) to the TRO-West office via fax or mail:
  • Fax:   (619)-231-4245
  • Mail:
    TRICARE Regional Office-West
    Attn: Prime Travel
    401 West A Street, Suite 2100
    San Diego, CA 92101-7908
Customer Comment Card
TRICARE Prime Travel Benefit
TPR Determination of Eligibility Enrollment Request Form
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