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40 Mile rule for Tricare


Chewy13

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Are you sure it's "within" 40 miles of a treatment facility because I think this would make you have to use the facility. Unless you live in a "BRAC" area like I do in Northern California. We are on Prime because of this or we would have to use Travis. You will probably have to change to standard. I'm sure some knowledgeable members will chime in.

 

James

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I think you'd get hard to answer questions from Prime if you had an address (like a mail service or part-year home base) within the 40 miles but got most of your care from other facilities. We switched to standard when we started RVing and are happy enough with it we have never considered Prime since we quit RVing.

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From https://www.hnfs.com/content/hnfs/home/tn/bene/enroll/prime_availability.html

 

 

 

If You Do Not Reside in a Prime Service Area

You may be able to enroll in a TRICARE Prime plan by waiving your drive time standards if you do not reside in a Prime Service Area. You must select a PCM in a Prime Service Area.

 

Hubby is on Tricare for Life, I am on Tricare Prime. My PCM is Nellis and I use a Pahrump NV address. I had to sign a waiver stating that I know my PCM is outside of the drive time standards for Tricare Prime.

 

 

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We have always used Tricare standard ( prior to aging into Tricare for Life) While on the road it meant a no hassle way to obtain care when and where we needed. Once we added up the premiums for prime it wasn't much of a leap to just self insure for the $3k annual cap.

To be honest even while Ron was active duty we always used civilian care with Tricare for the kids & I. As a nurse I wanted to chose consistent care for our family

Ron & Linda

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From https://www.hnfs.com/content/hnfs/home/tn/bene/enroll/prime_availability.html

 

 

Hubby is on Tricare for Life, I am on Tricare Prime. My PCM is Nellis and I use a Pahrump NV address. I had to sign a waiver stating that I know my PCM is outside of the drive time standards for Tricare Prime.

+1 for DW

Ron
US Army retired
2010 Tiffin Phaeton 40QTH
2016 Ford F150 XLT

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  • 4 months later...

We are currently seeking help for the same question. We are a family of 6 (4 young kids under 13). Standard would not be cost effective. We are trying to sell the house and move into the RV. Not possible with Prime. I called and called, the only answer is "you have to have a physical address". PO Boxes do not count. So my question is still the same as above. With a family, is traveling with no address possible with tricare prime? Worse case I rent a super cheap apartment and use that as storage.

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We are currently seeking help for the same question. We are a family of 6 (4 young kids under 13). Standard would not be cost effective. We are trying to sell the house and move into the RV. Not possible with Prime. I called and called, the only answer is "you have to have a physical address". PO Boxes do not count. So my question is still the same as above. With a family, is traveling with no address possible with tricare prime? Worse case I rent a super cheap apartment and use that as storage.

 

You CAN get a physical address. Several of the mail forwarding services are physical addresses. You just have to research them.

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We are currently seeking help for the same question. We are a family of 6 (4 young kids under 13). Standard would not be cost effective. We are trying to sell the house and move into the RV. Not possible with Prime. I called and called, the only answer is "you have to have a physical address". PO Boxes do not count. So my question is still the same as above. With a family, is traveling with no address possible with tricare prime? Worse case I rent a super cheap apartment and use that as storage.

We are a family of eight, and Standard wasn't cost effective for us. We stayed on Prime during our travels (PCM = Wilford Hall in San Antonio) but waived the 40 mile radius thing. We made our travel plans in order to return to the PCM area every few months to do maintenence medical stuff. We used the Escapees (Rainbow Drive) mailing address.

Stephen & Karen and our six boys, ages 21, 21, 19, 17, 14, & 11
Stephen - Military retiree (as of summer 2012) & current DOI employee (Big Bend National Park)
Karen - Homeschooling stay-at-home mom & veteran
San Antonio, Texas

Fulltimed May 2013 - July 2014 (yes, all eight of us!)
Open Range "Rolling Thunder" (H396RGR - fifth wheel toy hauler bunkhouse) - SOLD
Ford F-350 diesel dually - for the camper
Ford E-350 fifteen passenger van - for the crew

Our unfinished travel blog: http://coach-and-six.blogspot.com/

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In case you didn't know, it is VERY easy to get a referral direct from Tricare if you're out of your area. Last year my wife and I were in Albuquerque and got referrals to see a TriWest network provider for urgent care. Did the same in New Hampshire 2 yrs ago. Did not call our PCM at all. Went right to Tricare South for the referrals. They even helped us find providers.

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On the 40 mile rule for Prime we did a work around for our S&B address. It has been several years ago, but as I recall the local MTF is slightly less than 40 miles from our zipcode and my spouse (Tricare user, as I am on TFL) would have to go to the Air Force Base rather than our civilian physician for her primary care. The civilian physician's office is a mile or so beyond the 40 mile rule so we used the doc's zip code so we could continue to see the doc. We had to sign a document that we would pay, at our personal expense, the couple of miles to go see him for a visit. It beats traveling almost 40 miles to go to the base to see a medical provider.

Warren & Sandy

2006 New Horizons 36 ft 5ver

2003 Freightliner FL60 - Mountain Master conversion

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From https://www.hnfs.com/content/hnfs/home/tn/bene/enroll/prime_availability.html

 

 

Hubby is on Tricare for Life, I am on Tricare Prime. My PCM is Nellis and I use a Pahrump NV address. I had to sign a waiver stating that I know my PCM is outside of the drive time standards for Tricare Prime.

Same situation and same thing a waiver was signed. DW gets treatment all over.

Ron
US Army retired
2010 Tiffin Phaeton 40QTH
2016 Ford F150 XLT

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