In civilian HMOs, the beneficiary's primary care manager acts as a gatekeeper, overseeing and recording all treatments and medications, whatever their source. Portability of enrollment and reciprocity of care are other particular Prime problems, said Hickey. It is DoD policy that Prime enrollees should be able to transfer their policy from region to region when they move and that a recipient from one region should be able to receive care in another when traveling. But this flexibility has yet to be implemented in all areas of the country, claims the coalition. It can take weeks for Prime enrollees to transfer policies.
Reciprocity is scarcely more widespread.
This situation hampers beneficiaries who live near the border between regions, for example. Such basic standards as ease of access are not being met for Tricare Prime in many regions. Critics continue to insist that they have many instances where standards for time of access and distance to treatment are not being met. Interestingly, it is no longer civilian providers who are most often cited as the cause of these problems. Tricare Standard billing limits can also hinder beneficiaries.