TRICARE "Plus" Enrollment

A new TRICARE enrollment option called TRICARE Plus will allow some Military Health System beneficiaries to enroll with a military primary care provider. Enrollees will be provided access to primary care on the same basis as beneficiaries enrolled in TRICARE Prime.

The program is being finalized. Local timing and availability will vary, and opportunities may not exist at all military treatment facility locations. TRICARE Plus is open to persons eligible for care in military facilities and not enrolled in TRICARE Prime, or a commercial health maintenance organization (HMO). There is no annual enrollment fee.

Persons enrolled in TRICARE Plus will be identified in Defense Enrollment Eligibility Reporting System (DEERS), and will use the military treatment facility as their source of primary care.

The new program differs from TRICARE Prime and TRICARE Senior Prime in several ways:

TRICARE Plus is not a comprehensive health plan. TRICARE Plus is a primary care enrollment program ONLY, and has no effect on the enrollees' use or payment of civilian health care benefits. Thus, TRICARE Standard or TRICARE Extra or Medicare may pay for civilian health care services obtained by a TRICARE Plus enrollee.

TRICARE Plus does not lock beneficiaries in to "managed care." They may seek care from a civilian provider, but are discouraged from obtaining non-emergency primary care from sources outside the military treatment facility where they are enrolled. In addition to providing access to primary care, this plan enables their physician to coordinate health care more effectively.

TRICARE Plus does not guarantee enrollees access to specialty providers at the military treatment facility where they are enrolled.

TRICARE Plus is not portable. TRICARE Plus beneficiaries cannot use their enrollment at another facility.

The availability of TRICARE Plus in a location, and the number of enrollees, will be based on the local military treatment facility commander's determination of enrollment capacity. Should the number of applicants exceed the capacity for TRICARE Plus enrollment, enrollees will be selected by a fair process. Beneficiaries with existing primary care relationships at participating military treatment facilities, including those enrolled in the TRICARE Senior Prime demonstration, will have the first opportunity to enroll as long as a facility has the resources to provide the necessary primary care.

Military treatment facilities will review continued enrollment in TRICARE Plus annually. If capacity is no longer available at the military treatment facility, beneficiaries may be disenrolled. This will not affect their TRICARE or Medicare benefits.

For more information about TRICARE Plus, call 1-888-DOD-LIFE (1-888-363-5433), or visit the TRICARE Web site at: www.tricare.osd.mil/Plus .