TRICARE Prime for new families

Published March 12, 2008
By Nicole Krug
TriWest Healthcare Alliance

PHOENIX -- If you're expecting a new addition to your family this year, you have a lot to think about and probably more than a few questions. Getting TRICARE Prime or Prime Remote coverage for your new child is one of the important things you should be thinking about, and now it's easier than ever.

Whether welcoming a newborn or adopting, it pays for parents to understand how to get TRICARE Prime coverage for their child. If all of your bases aren't covered, you may receive unexpected bills for out-of-pocket fees.

New parents have 60 days from the date of birth or adoption to enroll their child into TRICARE Prime. On the 61st day, a child not enrolled in Prime will automatically be covered by TRICARE Standard.

You can still enroll you child in Prime, but the 20th of the month rule will apply. This means that if a completed application for Prime enrollment is received by TriWest on or before the 20th of the month, Prime benefits will go into effect on the 1st of the next month. If TriWest receives the application after the 20th of the month, the Prime enrollment will be effective on the 1st of the following month.

By taking a couple of baby steps within the first 60 days, you can keep your child's Prime coverage continuous:

1. DEERS (Defense Enrollment Eligibility Reporting System)

The first step is to add the child into DEERS. This must be done at a DEERS ID site. You may contact DEERS at 1-800-538-9552 to obtain the location of the ID Site nearest to you. An Application for Uniformed Services Identification Card and DEERS Enrollment Form (DD Form 1172) must be signed at the DEERS ID site by the sponsor. This form may be downloaded from www.triwest.com on the "Birth or Adoption" page of the "Life Changing Events" section. Additional documentation is required such as a birth certificate. For more specific information, please contact DEERS at 1-800-538-9552.

2. TRICARE Prime Enrollment

Once the child is enrolled in DEERS, he or she can be enrolled in Prime. You may now enroll your child online at TRICARE's Beneficiary Web Enrollment (BWE) site. Go to If you're expecting a new addition to your family this year, you have a lot to think about and probably more than a few questions. Getting TRICARE Prime or Prime Remote coverage for your new child is one of the important things you should be thinking about, and now it's easier than ever!

Whether welcoming a newborn or adopting, it pays for parents to understand how to get TRICARE Prime coverage for their child. If all of your bases aren't covered, you may receive unexpected bills for out-of-pocket fees.

New parents have 60 days from the date of birth or adoption to enroll their child into TRICARE Prime. On the 61st day, a child not enrolled in Prime will automatically be covered by TRICARE Standard.

You can still enroll you child in Prime, but the 20th of the month rule will apply. This means that if a completed application for Prime enrollment is received by TriWest on or before the 20th of the month, Prime benefits will go into effect on the 1st of the next month. If TriWest receives the application after the 20th of the month, the Prime enrollment will be effective on the 1st of the following month.

By taking a couple of baby steps within the first 60 days, you can keep your child's Prime coverage continuous:

1. DEERS (Defense Enrollment Eligibility Reporting System)

The first step is to add the child into DEERS. This must be done at a DEERS ID site. You may contact DEERS at 1-800-538-9552 to obtain the location of the ID Site nearest to you. An Application for Uniformed Services Identification Card and DEERS Enrollment Form (DD Form 1172) must be signed at the DEERS ID site by the sponsor. This form may be downloaded from www.triwest.com on the "Birth or Adoption" page of the "Life Changing Events" section. Additional documentation is required such as a birth certificate. For more specific information, please contact DEERS at 1-800-538-9552.

2. TRICARE Prime Enrollment

Once the child is enrolled in DEERS, he or she can be enrolled in Prime. You may now enroll your child online at TRICARE's Beneficiary Web Enrollment (BWE) site. Go to www.triwest.com and click the "Enrollment" link on the left-hand side under "Quick Links" to find the link to the BWE site, where you can enroll your child. You may also choose to download a TRICARE Prime Enrollment Application and PCM Change Form (DD Form 2876) found on the same page on www.triwest.com .

Both forms require you to identify your first and second preference for a Primary Care Manager (PCM), since the final PCM assignment is dependent upon provider availability and local Military Treatment Facility (MTF) policy.

If you are an Active Duty Family Member (ADFM) who would like to receive medical care from an MTF PCM, you should contact your TRICARE Service Center (TSC) before submitting your enrollment application. MTF provider assignments are coordinated at your MTF or through the local TSC. MTF providers are not listed in the online Provider Directory.

If you are mailing your forms, be sure to sign the form in either blue or black ink. Forms that are not signed and dated are considered incomplete and will be returned, delaying the enrollment process. Completed forms should be mailed to:

TriWest Healthcare Alliance
P.O. Box 41520
Phoenix, AZ 85080-1520

For questions or more information on how to enroll your new child, visit "Life Changing Events" in the Beneficiary section of www.triwest.com > . As a registered user, you'll get the latest TRICARE news about new services or changes that affect their benefits. West Region TRICARE beneficiaries may also call 1-888-TRIWEST (873-9378) for more information.
and click the "Enrollment" link on the left-hand side under "Quick Links" to find the link to the BWE site, where you can enroll your child. You may also choose to download a TRICARE Prime Enrollment Application and PCM Change Form (DD Form 2876) found on the same page on www.triwest.com.

Both forms require you to identify your first and second preference for a Primary Care Manager, since the final PCM assignment is dependent upon provider availability and local Military Treatment Facility , or MTF policy.

If you are an Active Duty Family Member, or ADFM who would like to receive medical care from an MTF PCM, you should contact your TRICARE Service Center, or TSC before submitting your enrollment application. MTF provider assignments are coordinated at your MTF or through the local TSC. MTF providers are not listed in the online Provider Directory.

If you are mailing your forms, be sure to sign the form in either blue or black ink. Forms that are not signed and dated are considered incomplete and will be returned, delaying the enrollment process. Completed forms should be mailed to:

TriWest Healthcare Alliance
P.O. Box 41520
Phoenix, AZ 85080-1520

For questions or more information on how to enroll your new child, visit "Life Changing Events" in the Beneficiary section of www.triwest.com. As a registered user, you'll get the latest TRICARE news about new services or changes that affect their benefits. West Region TRICARE beneficiaries may also call 1-888-TRIWEST (873-9378) for more information.

Enrolling newborns into TRICARE