martes, 27 de marzo de 2018

Comparing TRICARE Prime and TRICARE Select | Health.mil

Comparing TRICARE Prime and TRICARE Select | Health.mil

Health.mil

Comparing TRICARE Prime and TRICARE Select

Take Command logo



FALLS CHURCH, Va. — If you have health coverage with TRICARE, you can choose from a variety of plans, which provide you options in where and how you seek medical and dental services. Two major health programs include TRICARE Prime and TRICARE Select. Both require enrollment and each offer the quality care you deserve. Learn more about the available plans, so you can choose the program or programs that are best for you and your family members. 
TRICARE PrimeA managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.TRICARE Prime
TRICARE Prime is a managed care option and a health maintenance organization (HMO)-like program. It generally features the use of military hospitals and clinics and reduces out-of-pocket costs for authorized care provided outside military hospitals and clinics by TRICARE network providers. TRICARE Prime is mandatory for active duty service members (ADSMs) and is an option for their family members and certain TRICARE-eligible beneficiaries located in Prime Service Areas (PSAs) in the U.S.
In geographical areas where TRICARE Prime is not offered, TRICARE Prime Remote for Active Duty Family Members may be available as an enrollment option for eligible active duty family members (ADFMs). In overseas locations, TRICARE Overseas Program (TOP) Prime and TOP Prime Remote are available to ADSMs and their command-sponsored family members.
The US Family Health Plan (USFHP) is an additional TRICARE Prime option available through networks of community-based, not-for-profit health care systems in six areas of the U.S. To enroll in USFHP, you must live in one of the designated service areas.
Under a TRICARE Prime option, your health care is managed by an assigned primary care manager (PCM) and provided by a military or civilian network provider. Non-active duty enrolled beneficiaries will select or be assigned a PCM. TRICARE Prime PCMs may be:
  • At a military hospital or clinic
  • A civilian TRICARE network provider within a PSA
  • A primary care provider in the USFHP, depending on your location and sponsor status


Whether you receive care in the civilian sector or at a military hospital or clinic will depend on your location and the capacity at nearby military facilities.


TRICARE Select
On Jan. 1, 2018, TRICARE Select replaced TRICARE Standard and TRICARE Extra. TRICARE Select is a self-managed, preferred-provider option for eligible beneficiaries (except ADSMs and TRICARE For Life beneficiaries) not enrolled in TRICARE Prime. TRICARE Select allows you to choose your own TRICARE-authorized provider and manage your own health care.
Beneficiaries may receive enhanced TRICARE Select benefits from any TRICARE-authorized provider without a referral. You’ll have lower out-of-pocket costs if care is provided by a TRICARE-authorized network provider. Some services require prior authorization. You can also receive certain services from non-network, TRICARE-authorized providers, but will pay higher cost sharing amounts for out-of-network care. TRICARE won’t reimburse you for care received from non-authorized, non-network providers.
Under a TRICARE Select option, you pay a fixed fee for care for most services from a TRICARE network provider instead of paying a percentage of the allowable charge. As mentioned above, using a non-network, TRICARE-authorized provider results in both a higher deductible and out-of-pocket costs. In overseas locations, TOP Select is available to eligible ADFMs not enrolled in TOP Prime and to retirees and their family members. Where the TRICARE network has not been established in an overseas location, TRICARE Select beneficiaries who receive medically necessary covered services from a non-network, TRICARE-authorized provider will be subject to cost-sharing amounts applicable to out-of-network care.
Take command of your health by making informed decisions about your TRICARE benefit. Learn more about your TRICARE options.


Take Command: Changes coming to the TRICARE Retiree Dental Program

Article
3/19/2018
Official TRICARE logo
TRDP will end on Dec. 31, 2018
Recommended Content:
Access to Health Care | TRICARE Health Program

TRICARE Philippine demonstration ends, new preferred-provider network begins

Article
1/3/2018
Official TRICARE logo
Beginning Jan. 1, 2018, a preferred-provider network will be available in the Philippines.
Recommended Content:
TRICARE Health Program | Access to Health Care

TRICARE Changes Checklist

Fact Sheet
12/20/2017
Use this checklist as a guide to help Take command and prepare now for the changes coming in 2018.
Recommended Content:
TRICARE Health Program

Increases to TRICARE pharmacy copayments coming Feb. 1, 2018

Article
12/18/2017
TRICARE urges you to take command of your health care to enhance your TRICARE experience.
On Feb. 1, 2018, copayments for prescription drugs at TRICARE Pharmacy Home Delivery and retail pharmacies will increase.
Recommended Content:
TRICARE Pharmacy Program | TRICARE Health Program

TRICARE changes and network providers

Article
12/13/2017
TRICARE urges you to take command of your health care to enhance your TRICARE experience.
On Jan. 1, 2018, the current three U.S. TRICARE regions consolidate into two. New regional contractors will administer the TRICARE benefit for the East (Humana Military) and West (Health Net Federal Services, LLC) Regions. Due to these changes, it’s possible that your primary care manager (PCM) will no longer be in network.
Recommended Content:
TRICARE Health Program | New Regional Contracts to Administer the TRICARE Benefit

TRICARE Changes: Are you ready? #TakeCommand

Video
12/8/2017
TRICARE Changes: Are you ready? #TakeCommand
This video spot describes the changes that are coming in 2018.
Recommended Content:
TRICARE Health Program

TRICARE Changes: New Regions #TakeCommand

Video
12/8/2017
TRICARE Changes: New Regions #TakeCommand
This video spot describes how the three TRICARE regions are changing to two.
Recommended Content:
TRICARE Health Program | New Regional Contracts to Administer the TRICARE Benefit

TRICARE Changes: New Provider Directories #TakeCommand

Video
12/7/2017
TRICARE Changes: New Provider Directories #TakeCommand
To find a network providers in your region visit: TRICARE East- https://www.tricare-east.com TRICARE West- https://www.tricare-west-com
Recommended Content:
TRICARE Health Program

Military health: All for one, one for all

Article
12/1/2017
From left, Retired Army Maj. Gen. Richard Thomas, president of Uniformed Services University of the Health Sciences;  Navy Rear Adm. Colin Chinn, Joint Staff surgeon; Air Force Lt. Gen. Mark Ediger, Air Force surgeon general; Navy Vice Adm. Forrest Faison III, Navy surgeon general; Army Maj. Gen. Ronald Place, for the Army surgeon general; Navy Vice Adm. Raquel Bono, director of the Defense Health Agency; and Tom McCaffery, acting assistant secretary of defense for health affairs. (Courtesy photo)
Joint interoperability is theme of leadership session
Recommended Content:
MHS GENESIS | TRICARE Health Program

Improvements in preventive care coverage with TRICARE Select

Article
11/21/2017
TRICARE urges you to take command of your health care to enhance your TRICARE experience.
When TRICARE Select begins on Jan. 1, 2018, beneficiaries will notice improved coverage for preventive services
Recommended Content:
TRICARE Health Program | Preventive Health

Enroll now for 2018 TRICARE coverage

Article
11/14/2017
TRICARE urges you to take command of your health care to enhance your TRICARE experience.
If you want to switch to a different TRICARE health plan, or enroll in a plan for the first time, take action before Nov. 20, 2017
Recommended Content:
TRICARE Health Program

Print PSA: Enrollment Freeze

Publication
11/7/2017
Public service announcement you can print locally to help spread the word about the enrollment freeze in December.
Recommended Content:
TRICARE Health Program

Print PSA: Expanded Coverage for Mental Health and Substance Use Disorders

Publication
11/7/2017
Public service announcement you can print locally to help spread the word about the expanded coverage for mental health and substance use disorders.
Recommended Content:
TRICARE Health Program | Mental Health Care

Print PSA: TRICARE is Changing. Are you Ready?

Publication
11/7/2017
Public service announcement you can print locally to help spread the word about the upcoming changes to TRICARE.
Recommended Content:
TRICARE Health Program

Enrollment Freeze Calendar

Publication
11/7/2017
This calendar provides key dates surrounding the upcoming enrollment freeze in December.
Recommended Content:
TRICARE Health Program

No hay comentarios: