TRICARE Plus is a military treatment facility primary care enrollment program that is offered at selected local military treatment facilities. All beneficiaries eligible for care in military treatment facilities (except those enrolled in TRICARE Prime, a civilian HMO, or Medicare HMO) can seek enrollment for primary care at military treatment facilities where enrollment capacity exists. Non-enrollment in TRICARE Plus does not affect TRICARE For Life benefits or other existing programs. The following is a summary of the pros and cons of TRICARE Plus:
TRICARE Plus Benefits:
- Your primary care manager at the military treatment facility is your principal health care provider.
- You may still get care from civilian and/or Medicare providers. TRICARE Standard/Extra or Medicare rules apply. TRICARE will be second payer to Medicare for TRICARE-covered services for beneficiaries who are entitled to Medicare Part A and who have Medicare Part B coverage.
- You are not locked into an HMO-like program.
- There are no enrollment fees.
- You get primary care appointments with the same access standards as TRICARE Prime enrollees.
- TRICARE Plus enrollment is noted on your records in the Defense Enrollment Eligibility Reporting System.
TRICARE Plus Limitations:
- TRICARE Plus is not available at all military treatment facilities. Local commanders may continue or discontinue TRICARE Plus at their military treatment facilities depending on their capacities, capabilities and missions.
- TRICARE Plus is a military treatment facility primary care access program, not a health plan, so it has no effect on civilian provider care, and TRICARE Standard/Extra rules will apply for most enrollees.
- TRICARE Plus does not guarantee access to specialty care at the military treatment facility where you are enrolled.
- TRICARE Plus is not a portable benefit. Your enrollment at one facility does not guarantee access at another facility.
- We encourage TRICARE Plus enrollees to get all their nonemergency primary care at the military treatment facility where they are enrolled.
- The local military treatment facility reviews enrollment in TRICARE Plus annually. You may be disenrolled if capacity is no longer available.
Contact your local MTF for more information about TRICARE Plus in your area. To find an MTF near you, visit www.tricare.mil/mtf.
For general information about TRICARE, call one of the many toll-free TRICARE information lines found at the TRICARE Contact Us web page.