TRICARE Prime Remote

TRICARE Prime Remote is a managed care option available in remote areas in the U.S. By law, you can only use TPR if both your sponsor’s home and work addresses are more than 50 miles (or a one-hour drive time) from a military hospital or clinic.

• Check the Plan Finder to see if you may qualify.
• Enrollment is required.
• There are no enrollment fees.
• You may be reimbursed for reasonable travel expenses under the Prime Travel Benefit if you meet certain requirements.

Are you in a remote overseas location? You may be able to enroll in TRICARE Prime Remote Overseas.

Who Can Participate

TPR is available in designated remote locations in the U.S. for:

• Active duty service members
• Activated National Guard and Reserve members called or ordered to active duty service for more than 30 days in a row. (Pre‐activation, pre‐mobilization, pre-deployment, and TDY orders aren’t eligible.)
• Active duty family members who live with TPR-enrolled sponsor
• Activated National Guard and Reserve family members, if they live in a designated remote location when the sponsor is activated and continue to live at that address

To see if you live in a designated remote location:

• Check your ZIP code with the Plan Finder.
• Call your regional contractor.

How It Works

• You’ll get most care from your primary care manager.
  • You may have a network PCM, if available.
  • If a network PCM isn't available, choose any TRICARE-authorized provider as your PCM.
• Your PCM:
  • Refers you to specialists for care your PCM can’t provide
  • Works with your regional contractor for referrals and authorization
  • Helps find a specialist in the network
  • Files claims for you

What You Pay

Your costs depend on your beneficiary category.

• Active duty service members: No enrollment fees or out-of-pocket costs for covered care
• Active duty family members: No enrollment fees or network copayments. Point-of-service fees may apply.

Point-of-Service Fees

If you get nonemergency care without following referral rules, you’ll pay point-of-service fees instead of your usual copayment. These fees are much higher.

POS fees include:

• An annual deductible: $300 per individual or $600 per family
• Cost-shares: 50% of the TRICARE-allowable charge after you meet your POS deductible
• Additional charges: You may have to pay amounts charged by non-network providers above the TRICARE-allowable charge.

POS fees don’t count toward your annual catastrophic cap.

Note: If you’re an active duty service member, POS fees don’t apply to you. But you must still follow your plan’s referrals and pre-authorization requirements.

Is TRICARE Prime Remote right for you?

TPR is only available to active duty service members (including activated National Guard and Reserve members) and their families who live and work in designated remote locations.

• If you’re on active duty, you have to enroll in TPR if you live and work in a remote area.
• Family members can choose to enroll in TPR or TRICARE Select.
• TPR offers fewer out-of-pocket costs than TRICARE Select, but less freedom of choice for providers.
• If you have other health insurance, TPR might not be right for you.

How To Enroll

Visit TRICARE Prime Remote Enrollment to learn more.

For information on disenrolling or ending plan coverage, visit Disenrolling From TRICARE Prime Remote.

Looking for information on Determination of Eligibility requests? Learn more.

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