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Access to Care: Located Greater Than 100 Miles from PCM

TRICARE Prime Access to Care standards help ensure that Prime enrollees have convenient access to medical care by requiring that Prime beneficiaries live less than 30 minutes away from their primary care manager (PCM). Recent changes to TRICARE enrollment access standards state that beneficiaries living more than a 100 mile drive from their military PCM will require permission from the Director, TRICARE Regional Office-West, to remain enrolled at the military treatment facility.

Affected beneficiaries can request a waiver to remain enrolled to the military PCM. Fill out and submit a new TRICARE Prime enrollment application:

You will be notified by mail of the decision.

Your other TRICARE options may include:

  • Use TriWest’s online Provider Directory to find local PCMs (be sure to check the “PCMs only” box). If an available PCM is within a 30-minute drive of where you live, you can request (online or by mail) a new PCM or you will be automatically assigned a new PCM effective October 1, 2009. TriWest will send you a letter listing your new PCM.
  • If a civilian network PCM is not available within 30 minutes of where you live, you will be disenrolled from TRICARE Prime (effective October 1, 2009) and will be eligible to use TRICARE Standard and Extra. You will be notified of your disenrollment by mail.
  • If you reside 100 miles or more from a civilian network PCM, you will no longer be eligible for TRICARE Prime enrollment. You will be eligible to use TRICARE Standard and Extra.
You can always verify and update your DEERS information in a number of ways:

Published Date: 07/16/2009