TRICARE Prime a Matter of Geography

NGAUS Washington Report

(Jan. 15, 2013) Recipients of TRICARE Prime who live more than 40 miles from a military treatment facility or base closure site will have to move to a fee-for-service version of the health insurance.

As of Oct. 1, TRICARE Prime, the military’s managed-care option, will end for users beyond the geographic limit that will go into effect. Those people will shift to TRICARE Standard.

The Defense Department expects to save between $45 million to $56 million annually with this switch.

Those affected live outside the 40-mile limit around a treatment facility or a site affected by the 2005 base closure and realignment process.

S. Dian Lawhon, the TRICARE director of beneficiary education and support, told columnist Tom Philpott that letters will be mailed within 30 days to those affected by the change in policy.

It’s possible for TRICARE Prime recipients to remain in that program if they live less than 100 miles from an existing Prime network, but they have to be willing to waive the driving-distance standard imposed by TRICARE. The standard is designed for patient safety, the provider says.