TRICARE Plus Limitations:
o TRICARE Plus will not be available at all military treatment facilities. Local commanders will retain discretion to continue or discontinue TRICARE
Plus at individual military treatment facilities depending on their capacities/ capabilities and missions.
o TRICARE Plus is a military treatment facility primary care access program, not a health plan. For care from civilian providers, TRICARE Plus has no effect and TRICARE Standard/Extra rules will apply for most enrollees. For
services payable by Medicare, Medicare rules will apply, with TRICARE as second payer for TRICARE covered services and supplies.
o TRICARE Plus does not guarantee access to specialty care at the military
treatment facility where the beneficiary is enrolled.
o Prospective enrollees will apply for enrollment in TRICARE Plus. Enrollment may be determined, in part, by the specific missions and needs of
each military treatment facility (for example, GME, existing TRICARE Senior
Prime program, etc.).
o TRICARE Plus is not a portable benefit. Enrollment at one facility will
not guarantee access at another facility.
o TRICARE Plus enrollees are discouraged from obtaining nonemergency
primary care from sources outside the military treatment facility where they are enrolled.
o Beneficiaries enrolled in an HMO or similar program of another sponsor (TRICARE Prime, employer-sponsored HMO, Medicare Choice) are not eligible for TRICARE Plus because they have an established primary care relationship.
o Continued enrollment in TRICARE Plus is reviewed annually by the local military treatment facility; beneficiaries may be disenrolled if capacity is no longer available.
