Understanding Tricare benefits while traveling Published April 29, 2004 By Airman 1st Class Katie Booher 5th Bomb Wing Public Affairs MINOT AIR FORCE BASE, N.D. (AFPN) -- It is easy for a person to access his or her health benefits at home, but it can get complicated when they going on vacation across America or overseas.Emergencies, including injuries threatening someone’s life, limb or eyesight, are covered by Tricare Prime; but, the beneficiary still has some responsibility for getting in touch with the medical facility at his or her home base, said Terri Bell, 5th Medical Support Squadron beneficiary counseling assistance coordinator.“If a Tricare Prime beneficiary, whether active duty, retiree or family member, is confronted with an emergency while traveling, they should seek immediate care at the nearest hospital emergency room,” she said. “However, members should be sure to notify their primary care manager within 24 hours to initiate a record of the care they are receiving. Members on the personnel reliability program or flying status must notify the PRP section or flight medicine as soon as possible after receiving treatment.”Urgent care is also covered; however, all Tricare Prime beneficiaries must contact their primary care manager to obtain authorization before seeking care, Ms. Bell said.“If a beneficiary seeks care from a civilian provider and doesn’t receive a prior authorization for the care, they’ll be billed under the point-of-service option, and they will pay a higher cost-share and a $300 deductible,” she said. “Active-duty members will be responsible for the total charges.”Beneficiaries should take their prescription medication and immunization records with them on vacation, but if they are on maintenance medication, they can receive a 90-day supply, Ms. Bell said.“If people are traveling within their Tricare region and need medication, they only have to pay the copayment by using a network pharmacy,” she said. “If members must fill a prescription while outside of their region, they will have to pay the entire amount and seek reimbursement from Tricare once they return.”Under the new pharmacy contract, Ms. Bell said there will be only one claims processor for pharmacy claims. When beneficiaries use a network pharmacy, their claims will be processed online; however, they are also responsible for covering their $3, $9 or $22 copayment.When traveling outside the United States, patients pay the bill upfront, but Tricare will reimburse them when they return, Ms. Bell said.“Because the Code of Federal Regulations doesn’t permit direct payment of medical or dental claims to a foreign provider, the patient must pay the bill upfront,” she said. “When the patient gets home, (he or she can) file a claim directly with Tricare.”For more information on these and other military health-care benefit issues, call the local Tricare office.