Primary Care Manager
What is a primary care manager (PCM)?
All Prime enrollees select or are assigned a PCM. The PCM is responsible for providing you all routine, non-emergency, and urgent health care. Your PCM:
- Can be a military or network provider.
- Will accept your copayment and file claims for you.
- Will give you a referral to see a specialist for any care he or she can't provide.
When you don't get a referral from your PCM, it's called point-of-service. When you use point-of-service, you pay higher out-of-pocket-costs including a deductible which doesn't count toward your annual catastrophic cap.
You may request to change your PCM at any time. Your request:
- Must comply with guidelines at the local military hospital or clinic.
- May take up to 6 days to confirm.
Find a New PCM
Search your region's provider directory to find a new PCM near you. Call first to see if they are accepting new patients.
Change Your PCM
1. Call your Regional Contractor
- North: Health Net (1-877-TRICARE)
- South: Humana-Military (1-800-444-5445)
- West: UnitedHealthcare (1-877-988-WEST)
- Go to the Beneficiary Web Enrollment website
- Click on the red "Log On" button at the top of the page
- Click on the "Change Primary Care Manager" button in the Actions Menu
3. In the Mail
Mail a TRICARE Prime Enrollment, Disenrollment and PCM Change Form to your regional contractor with the new PCM's name and address (mailing address is found on Page 3 of the form). You only need to complete the part of the form related to the PCM change.
The change is effective when your regional contractor processes the PCM change. You'll get a letter with your new PCM's name and telephone number. Write this information on the back of your enrollment card.