Military Treatment Facility (MTF) staff, Regional Office personnel,
and TRICARE Prime beneficiaries should familiarize themselves
with these important TRICARE travel benefits.
Section 758 of the FY2001 National Defense Authorization
Act (NDAA) authorized reimbursement of reasonable travel expenses
incurred by non-active duty TRICARE Prime members when they
are required to travel more then 100 miles from their Primary
Care Manager’s (PCM) office for medically necessary specialty
care. The required change to the Joint Federal Travel Regulation
approving this new entitlement occurred in December 2001.
The Prime travel benefit was implemented on February 15, 2002
but also dates back to October 30, 2000 to allow Prime members
who traveled and qualified for the benefit to request reimbursement.
Section 706 of the FY2002 NDAA allows one NMA to travel with
a non-active duty TRICARE Prime member who is referred more
than 100 miles from their PCM for medically necessary specialty
care. The traveling patient’s PCM must indicate that an NMA
is medically necessary and appropriate and the NMA must be
a parent, guardian, or another family member (21 or older)
related to the traveling TRICARE Prime member. If the NMA
is a parent or designated guardian of the traveling Prime
patient he/she is not required to be 21 or older. If the NMA
is another adult family member, he/she is required to be 21
Prime Travel benefits are determined based on the distance
of the specialty care provider from the Primary Care Manager’s
location The link is limited to use by government individuals
and will assist in determining whether or not the more than
100 mile requirement is met. Entries are based on the zip
code of the Primary Care Manager (not the patient zip code)
and the Specialty Provider. This is the only tool to be used
in determining the distance requirement. Click on the Defense
Table of Official Distances to determine distance.
Costs (Lodging, meals, per diem)
The Prime Travel entitlement allows beneficiaries to be reimbursed
for certain travel costs and other associated expenses like
lodging and meals. Actual expenses are reimbursed up to the
government rate. If beneficiaries have questions regarding
government/per diem rates, the following web link provides
this information. Beneficiaries will be responsible for all
costs exceeding the identified government rate. Click on the
2004 Contiguous US Per Diem Rates to determine rates.
For more information regarding these entitlements, we encourage
to browse through the other links on this webpage or call
the Patient Travel Representative or Beneficiary Counseling
and Assistance Coordinator (BCAC) at the MTF where you are
enrolled. If you are enrolled with a civilian network PCM,
please contact the Patient Travel Representative or BCAC at
Regional Office in the region where you are enrolled.