Overseas members entitled to stateside care

  • Published
  • By Kevin M. Hymel
  • Air Force Surgeon General Public Affairs
Overseas military families may face a problem when they return home to the United States for the holidays.

Service members and their families enrolled in the TRICARE Overseas Program (TOP) Prime Remote are entitled to visit hospitals and clinics stateside and receive the same priority status as stateside enrollees. However, many of these overseas members are being denied access to care at medical treatment facilities simply because they are not enrolled to the MTF where they are seeking care.

The Health Affairs Policy 11-005 provides guidance for the access to care standards for health care benefits under the TRICARE program for beneficiaries. Priority access to MTFs is based on enrollment status, and Prime/Prime Remote enrollees have priority access for care ahead of non-enrolled beneficiaries in all MTFs, according to the policy.

If TOP Prime/Prime Remote enrollees need care at a stateside MTF, TRICARE reminds those MTFs that this is an opportunity to support military readiness, recapture patients and keep costs low for the Military Health System. Generally, beneficiaries not seen at military hospitals and clinics are seen by civilian providers at a higher cost.

To learn more about the TRICARE health plan, visit TRICARE’s SMART site for access to fact sheets and brochures on how each plan works.