TRICARE Prime Enrollment for E-1 Through E-4 and Their Families

Active duty family members of E-1 through E-4: Are you aware that enrolling in TRICARE Prime increases your access to care at a military treatment facility (MTF), and reduces your potential out-of-pocket costs? Were you aware the one-year lockout provision for early TRICARE Prime disenrollment for you is eliminated? Did you know effective April 1, 2001, copayments (except for civilian pharmacy) were eliminated for TRICARE Prime enrollees? Read on, the news from TRICARE Management Activity (TMA) regarding your health care benefit gets even better.

Beginning June 2001, sponsors of family members E-1 through E-4 who have not enrolled in TRICARE Prime will receive a letter from TMA. It will encourage them to contact or visit their nearest TRICARE service center (TSC) representative to discuss their individual family members' health care needs and benefit options.

"While the vast majority of active duty family members, E-1 through E-4, have already enrolled in TRICARE Prime, some may not be. There may be exceptions, but we believe TRICARE Prime is the best option for most of these families," said Thomas F. Carrato, executive director, TMA.

Benefits of TRICARE Prime enrollment include priority access at the military treatment facility, timely access to a designated primary care manager, minimal out-of-pocket costs and no claim forms for family members to file. Family members of E-1 through E-4 sponsors can also elect to disenroll at any time and are not subject to the one-year lockout for early disenrollment.

"Our goal is to ensure that these families have the most up-to-date information available to them, so that they can make an informed decision to enroll in TRICARE Prime, or decline enrollment and continue using the TRICARE Extra/Standard benefit," said Carrato.

After the initial mailing of the letter from TMA, the primary means of identifying these families will occur during in-processing.

"We hope to identify these families as the sponsor reports to his/her new duty assignment," said Air Force Lt. Col. Loretta Bailey, enrollment project officer, TMA.

"We will depend on the support of unit commanders, first sergeants and local installation support services who have direct contact with these families to refer non-enrolled family members, who are not identified during in-processing, to the TRICARE service center for assistance," according to Bailey.

Family members who elect TRICARE Prime will complete an enrollment application. The application will document the family member's enrollment information and preferences related to selection of a primary care manager (PCM). Once enrolled, the family member's enrollment is portable and can be transferred an unlimited number of times between TRICARE regions as the family relocates. Enrollment in TRICARE Prime for individuals other than those on active duty is voluntary. Family members retain the right to decide which of the three options -- TRICARE Prime, Extra or Standard -- best meet their health care needs, and may terminate their enrollment in TRICARE Prime at any time. To disenroll, the sponsor or the family member must notify their regional managed care support contractor.

"We continually seek ways to make the TRICARE benefit even better and more convenient for our beneficiaries. Enrolling our junior enlisted family members in TRICARE Prime will guarantee them priority access," said Carrato.

Additional information on TRICARE Prime enrollment is available on the Military Health System/TRICARE Web site at www.tricare.osd.mil , or by contacting a local TRICARE service center representative.