Managed Care at Fort Irwin

The Managed Care Division serves as the primary liaison with the TRICARE Managed Care Support Contractor, Health Net Federal Services, ensuring delivery of the enhanced healthcare benefits of TRICARE health plans. It is also responsible for developing partnership and sharing agreements with external healthcare sources, such as the Department of Veterans Affairs local and regional Department of Veterans Affairs hospitals and coordinating care for DOD beneficiaries with other healthcare facilities when WACH is unable to provide needed services.

Services Provided:

• Enrollments and Primary Care Manager (PCM) changes
• Referral Management
• TRICARE Prime Travel Benefit Program Administration

Managing Your Enrollment

TRICARE Enrollment

• Welcome to TRICARE - An Overview of Your TRICARE Benefit in the U.S. video

• Ensure that the address on enrollment form is within 100 miles of Fort Irwin, active duty service members ensure UIC is correct on enrollment form

• PCM assignments are determined by your residential location, Military Treatment Facility (MTF) guidelines, PCM availability and TRICARE access standards.

• To request enrollment to a Primary Care Manager within the Fort Irwin area, beneficiaries may call Health Net Federal Services at 844-866-9378 (please ensure you also update your residential address at this time if you are relocating to Fort Irwin), or present to the Managed Care Division within Weed Army Community Hospital.  Dependents may also utilize the TRICARE Beneficiary Web Enrollment (BWE) by visiting https://milconnect.dmdc.osd.mil/milconnect/ and selecting “Manage Health Benefits.”

• Newborn Enrollment: You must register your newborn in DEERS within 90 days of birth (stateside) to retain TRICARE coverage.  If you do not register your child in DEERS within 90 days, your child will no longer show as TRICARE eligible and claims for your child will begin to deny starting when the child is 91 days old (stateside).  Your child also may not automatically be enrolled in Prime, contact Health Net Federal Services, utilize the BWE, or contact the Enrollments Section of the Managed Care Division to ensure proper enrollment to the MTF.

• To find out more regarding TRICARE enrollment please visit https://tricare.mil/plans/enroll.  For additional information to better manage your TRICARE benefits, please take advantage of the many webinars offered by visiting https://tricare.mil/Resources/MediaCenter/TRICARE-Webinars.

Changing Your Primary Care Provider (PCM)

• To request a Primary Care Manager change within Weed Army Community Hospital beneficiaries must present to the Managed Care Division or call 760-383-5491 for assistance. 

• PCM changes cannot be processed online or by contacting Health Net Federal Services.

• Be advised PCM assignments are determined by PCM availability, therefore, not all requests are approved.

• Soldiers assigned to the Javier Villanueva Troop Medical Clinic (JVTMC) requesting a PCM change not based on UIC assignment must make their request through the Patient Advocate (760-383-5099).

• Are you unsure of who your Primary Care Manager is?  If so, visit https://myaccess.dmdc.osd.mil, DS logon required.  Once logged in select the MHS Genesis Patient Portal, under the menu on the left side, select “View Patient Information/PCM”.  Your PCM will be listed at the very bottom under “Medical Contacts”.  For any dependent children, select the drop-down menu at the top of the screen under “Patient Information” and choose another family member.  Their PCM will again be listed at the bottom of the screen.

 TRICARE Prime Travel Benefit

• IMPORTANT: ALL ACTIVE DUTY service members’ units are responsible for processing reimbursements to them for their off-post medical appointments.

• The Prime Travel Benefit reimburses reasonable expenses for a qualified trip by a non-active duty TRICARE Prime enrollee.

• The enrollee MUST be assigned to a PCM in the US.  To be processed by WACH, the enrollee must be assigned to a PCM within the catchment area.

• The enrollee’s PCM refers them for non-emergent, medically necessary (to be medically necessary means it is appropriate, reasonable, and adequate for the enrollee’s condition) care covered by TRICARE.

• A trip for health services not covered by TRICARE does not qualify for reimbursement.

• The enrollee’s referral is to a specialty care provider who is more than 100 miles (one-way) from the PCM’s office.

• There is no suitable military, network, or non-network TRICARE-authorized specialty care provider within 100 miles of the enrollee’s PCM available to provide the referred care.

• For further information on the TRICARE Prime Travel Program, visit https://tricare.mil/primetravel.

Travel for an Approved Non-Medical Attendant (NMA)

• 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 years of age or older, the referring or treating provider must verify in writing that the NMA is medically necessary for the patient’s trip.

• The traveler must submit all itemized travel receipts, including expenses less than $75.00.

• TRICARE will not reimburse travelers for the same expense. This includes shared expenses like lodging or car rental.

• For further information on NMA reimbursement, visit https://tricare.mil/primetravel.