MEDICAL SPECIALISTS: A network physician or other health care professional, usually with special advanced education and training, who generally provides services other than what a primary care manager (PCM) offers. HOSPITAL/CLINICS/OTHERS: Network locations such as medical/surgical hospitals, clinics, ambulatory surgery centers and skilled nursing facilities. Additionally, TRICARE beneficiaries may see a TRICARE-certified licensed professional counselor (LPC), mental health counselor (MHC) or pastoral counselor provided they are referred by a physician (MD or DO) who also supervises the care. Members can see any TRICARE network or non-network provider and are responsible for calendar year deductibles and cost-shares/copayments.īEHAVIORAL SPECIALISTS: These include network providers of mental health care certified by TRICARE, which may include psychiatrists (MD), psychologists (PhD), licensed clinical social workers (LCSW), marriage and family therapists (MFT) and certified psychiatric nurse specialists. TYA Select provides health care coverage similar to TRICARE Select. TRICARE Young Adult (TYA) Select is a premium-based option for young adults who have aged out of TRICARE and are under age 26. Beneficiaries enrolled in TYA Prime Remote have a primary care manager (PCM) and may require prior authorization and/or referrals for specialty care. TYA Prime Remote provides coverage similar to TYA Prime for young adults who reside with their active duty sponsor in a TRICARE Prime Remote area. TRICARE Young Adult (TYA) Prime Remote is premium-based option for young adults who have aged out of TRICARE and are under age 26. TYA Prime is only available in certain areas and enrollees may require prior authorization and/or referrals for specialty care. Beneficiaries enrolled in TYA Prime have a primary care manager (PCM) and receive their care from the military treatment facility (MTF) or the TRICARE network of civilian providers. TRICARE Young Adult (TYA) Prime is the premium-based managed health care option for young adults who have aged out of TRICARE and are under age 26. Members can see any TRICARE network or non-network provider and are responsible for calendar year deductibles and cost-shares/copayments. TRICARE Retired Reserve (TRR) is a premium-based plan available to qualified Retired Reserve members, family members and survivors, offering health care coverage similar to TRICARE Select. TRICARE Reserve Select (TRS) is a premium-based plan available to qualified National Guard and Reserve members, family members and survivors, offering health care coverage similar to TRICARE Select. Beneficiaries can see any TRICARE network or non-network provider and are responsible for calendar year deductibles and cost-shares/copayments. TRICARE Select is a preferred provider option available to all TRICARE-eligibles except active duty service members. Beneficiaries enrolled in TPR have a primary care manager (PCM) and may require prior authorization and/or referrals for specialty care. Retired service members and their families are not eligible for TPR. TRICARE Prime Remote (TPR) provides health care coverage similar to TRICARE Prime for active duty service members and their families who are on remote assignment. TRICARE Prime is only available in certain areas and enrollees may require prior authorization and/or referrals for specialty care. TRICARE Prime enrollees have a primary care manager (PCM) and receive their care from a military hospital or clinic, also referred to as a military treatment facility (MTF), or the TRICARE network of civilian providers. TRICARE Prime is the managed health care option for active duty services members, retired service members and their families.
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