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Issue Summary

Regional Portability of TRICARE Boundaries

Issue Number 505
Status Completed
Issue Title Regional Portability of TRICARE Boundaries
Scope TRICARE regional boundaries are too restrictive. There are currently 13 TRICARE regions. Beneficiaries experience difficulties when requiring medical care from a region other than their own. These regional boundaries cause complications for beneficiaries by limiting choices, complicating claims, delaying medical care and creating administrative authorization problems.
Issue Recommendation Reduce the number of TRICARE regions. Allow beneficiaries to access routine and specialized medical care in other regions.
Military Component Active Component
Demographic Group Family Members, Soldiers, Retirees
Subject Area Medical
Geographic Area Universal
Entered AFAP Mar 2002
Final Action Date May 2005
Accomplishments The TRICARE Management Activity replaced the previous 11 CONUS contracts with 3 contracts in Aug 03. The “by-Region” transition to the new contracts was completed on schedule on 01 Nov 04. The recommendation to allow beneficiaries to access care in other regions was not supported. TRICARE Prime requires managed care notifications/authorizations for care outside the region for care continuity, claims and cost accounting.
Outstanding Requirement
Submitting Command US Army Material Command, US Army Space & Missile Defense Cmd
For any questions regarding this issue, please alert the point of contact via email.

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