TRICARE Announces Plan for Reinstating Certain Beneficiaries to TRICARE Prime

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If you are one of thousands of beneficiaries who lost eligibility for TRICARE Prime last October when TRICARE redefined the Prime Service Areas (PSAs), you may have an opportunity to re-enroll. Approximately, 76,000 TRICARE beneficiaries (mainly retirees and family members) will receive letters informing them of the re-enrollment process.

To be eligible to make this one-time election to re-enroll in TRICARE Prime, a dis-enrolled beneficiary must reside in a ZIP code that was a PSA as of September 30, 2013 and live within 100 miles of a military medical treatment facility.

TRICARE will notify eligible beneficiaries by mail. The letters were mailed at the end of April and beneficiaries have until June 30, 2014 to make their one-time election. To re-enroll, the beneficiary must do the following:

The managed care contractor for the beneficiary’s region will assist in reviewing the available PCMs.

Once eligible beneficiaries re-enroll, their Prime enrollment will be effective back to October 1, 2013. Beneficiaries are responsible for paying retroactive enrollment fees. Any claim processed during the retroactive period will be reprocessed as a TRICARE Prime claim.

Beneficiaries who choose not to re-enroll will not need to take any action. They will remain on TRICARE Standard.

For more information on TRICARE Prime re-enrollment, please see the TRICARE website. 

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