Tri-Care Prime Managed Care Health Insurance Plans

Part 2, Chapter 8: CHAMPUS and Medical Savings Accounts Page 3

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Tri-Care Prime centers are already in operation in two-thirds of the country, particularly in the south, southeast, and west. Additional Tri-Care Prime centers are scheduled to be established in the remaining areas of the country within the next few years. Eventually, Tri-Care Prime is expected to become one of the standard ways of providing medical care to eligible individuals throughout the country.

As with most managed care plans, the Tri-Care Prime system offers important benefits to participants. For example, there are usually no claim forms to fill out, and some preventive care -- screening tests, for example -- is usually covered. However, Tri-Care participants must generally obtain approval from their primary care physician for tests and consultations with a specialist.

CHAMPUS does not operate Tri-Care centers directly. Instead, CHAMPUS contracts with various agencies and organizations to administer Tri-Care in different areas of the country.

The basic rules of the CHAMPUS program are described in the CHAMPUS Handbook. If you live near a military base, you may be able to obtain a copy of that handbook from the base health benefits advisor. You can also order the book directly from the national Tri-Care Support office (See Appendix B).

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