TRICARE Prime Travel Benefit

What is the Prime Travel Benefit?

The Prime Travel Benefit reimburses reasonable travel expenses for a qualified trip by a TRICARE Prime enrollee. Reasonable expenses are the amounts you pay when traveling to and from your appointment. This includes mileage, meals, tolls, parking, lodging, local transportation, and tickets for public transportation.

Does Your Trip Qualify for the Prime Travel Benefit?

Your trip may qualify for reimbursement if you’re enrolled in TRICARE Prime or TRICARE Prime Remote for Active Duty Family Members and:

• You, as the patient are:
  • NOT an active duty service member (ADSM).
  • NOT an active duty family member living with your active duty sponsor on orders in Alaska and Hawaii.
•  You are assigned to Primary Care Manager (PCM) in the United States.
• Your PCM refers you for non-emergency, medically necessary (To be medically necessary means it is appropriate, reasonable, and adequate for your condition.) care covered by TRICARE.
  • A trip for health services not covered by TRICARE doesn't qualify for reimbursement.
• You have a referral to a specialty care (Specialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide.) provider who is more than 100 miles (one-way) from your PCM’s office.
• There’s no suitable specialty care provider within 100 miles of your PCM to provide the referred care. This includes military, network, or non-network TRICARE-authorized providers.

Does the Prime Travel Benefit Cover a Non-Medical Attendant (NMA)?

It depends. Travel for an approved NMA may qualify for the Prime Travel Benefit.

• The patient’s trip must qualify for the Prime Travel Benefit (as described above) and the NMA must travel with the patient on that qualified trip.
• The NMA must be a parent, spouse, other adult family member (age 21 years or older), or a legal guardian.
  • If the patient is 18 or older? The referring or treating provider must verify in writing that the NMA is medically necessary for the patient’s trip.
•  You must submit all of your itemized travel receipts, including expenses less than $75.00.
  • TRICARE won’t reimburse travelers for the same expense. This includes shared expenses like lodging or car rental.

Note: Are you an Active Duty Service Member?

If you are traveling as the patient:

• The Prime Travel Benefit won’t apply. Contact your unit's travel representative for guidance.

If you're traveling as a non-medical attendant:

• Is the patient an Active Duty Service Member (ADSM)?
  • If yes, The Prime Travel Benefit won’t apply. Contact your unit's travel representative for guidance 

If the patient:

• Is a TRICARE Prime enrollee and;
• Is NOT an ADSM and;
• The patient’s trip qualifies for Prime Travel Benefit.

Then, contact your servicing Prime Travel Benefit office. See below on how to contact your Prime Travel Benefit office.

Does Your Trip Qualify For Lodging?

Lodging is authorized reimbursement if patient appointment time requires travel during “dark hours” of 2400-0600 as per the JTR Chapter 2 para 020202. Excluded Hours. Appointment verification from provider office indicating time of appointment or reporting time is required to receive reimbursement.
 

How to Initiate a Reimbursement?

Travel reimbursement claims must be filed no later than one year after the qualifying return travel date. It is highly recommended to file for reimbursement within 30 days of travel.

If you have reviewed the above information and believe you qualify please download appropriate forms below.

Send all forms and travel correspondence (including all itemized receipts) to:
usarmy.irwin.medcom-wach.mbx.prime-travel-benefit-program@health.mil. 

 

If you have additional questions, please visit the Prime Travel Website: https://www.tricare.mil/PrimeTravel.