New to TRICARE? Here’s a quick cheat sheet on how to get the care you need.
Choose Your Plan
All active duty and their families – by default – will be under TRICARE Prime. See this post to learn more about the different options.
Tricare Open Season
TRICARE Open season is the annual period when you can enroll in or change your health care coverage for the next year. Open Season runs from the Monday of the second full week in November through the Monday of the second full week in December. Enrollment changes go into effect on Jan. 1st of the following year.
Open season applies to anyone enrolled in or eligible for a TRICARE Prime option, including the US Family Health Plan (USFHP), or TRICARE Select. Open season is the only time of the year you can switch plans, unless you have a “qualifying life event.”
If you’re interested in Dental and Vision, there is also an Open Season for that.
Primary Care Manager (PCM)
If you’re on Prime you will need to establish care with a Primary Care Manager (PCM) in order to get referrals for specialty care. You may have been automatically assigned one and can find that information by logging in to Beneficiary Web Enrollment.
If you want to change your PCM you can search online in the directory specific to your region to find one. You may want to call these places to see when they have appointments available!
- West: Health Net
- East: Humana Military
Once you identify the doctor you want to see, go to the milconnect website and navigate to the Change PCM button under Beneficiary Web Enrollment. See this site for detailed steps.
Switching Regions
When you PCS, you may need to switch regions depending on the duty station. TRICARE is divided up into two regions, West: Health Net and East: Humana Military. Your benefits are the same no matter where you live, there are just different customer service contacts for each.
Crowdsourcing on Facebook
Local Facebook groups are a great resource to search previous posts or ask others what doctors they use and trust. Likewise, they can be great resources for what doctors or medical groups to avoid.
Access to Care Standards
Be aware of access to care standards! If you’re being told you have to wait months to be seen, keep looking or contact Tricare for help. Under Prime you should be able to see your PCM the same week and a specialist within four weeks.
Emergency Rooms & Urgent Care
Have an acute issue? You can go to a local MTF emergency room or urgent care without a referral in most instances. Check your specific plan and situation here.
Did you find this article helpful? What other Tricare questions do you have? Comment below!