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Plan Overview & Eligibility

When you enroll in the Kaiser Permanente TRICARE Prime option, you can enjoy:

  • Complete TRICARE Prime health coverage through the Kaiser Permanente model of coordinated care.
  • $0 annual enrollment fee for the 1st year. After the 1st year the annual enrollment fee will be the same as TRICARE Prime.
  • Up to $400 per household each year in wellness rewards – $200 for you and $200 for your enrolled spouse.
  • The same costs and benefits as TRICARE Prime with some pharmacy differences and other minor variations. See our pharmacy section and minimal variations pdf for details.
  • The Kaiser Permanente network of over 800 doctors in our 25 facilities and Kaiser Permanente contracted providers when in the metro Atlanta area. Most facilities provide many services including doctors, lab, x-ray, and pharmacy – all under one roof.
  • Access to military hospitals and clinics anywhere (if space is available).
  • Top-notch doctors
    • Choose your own Primary Care Physician (like a PCM) and change any time
    • See most specialists without a referral
    • All our available doctors welcome Kaiser Permanente TRICARE Prime option members.
    • Learn more.
  • Care coordinated for you – our doctors, specialists, pharmacies, hospitals, and other caregivers are all connected. Learn more.
  • No-cost care options, free programs, and discounts:
  • A free app to schedule appointments, refill prescriptions, view your medical record, and more.
  • Access to the Kaiser Permanente network AND the TRICARE network of doctors and facilities when traveling outside of Georgia.

Are you the only family member who wants to enroll or a student studying in Atlanta?
You can choose this option even if other family members want to stay with their existing TRICARE option.

Who is eligible

If you are eligible for TRICARE Prime and:

  • live in the metro Atlanta area (check ZIP Code below),
  • are under the age of 65, and not entitled to Medicare Part A and B,
  • do not have other health insurance,
  • are not enrolled in TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), TRICARE Young Adult (TYA), or Continued Health Care Benefit Program (CHCBP),
  • are not receiving services for an autism diagnosis, AND
  • are a retiree, family member of a retiree, or an active duty family member,

you may be eligible to enroll in this option.

Note: Active duty service members and TRICARE Young Adult Prime beneficiaries are not eligible for Kaiser Permanente, a TRICARE Prime Option.

To verify eligibility, call Humana Military at 1-877-414-9950.

Check if your ZIP Code is in the metro Atlanta covered service area.

Switching plans is simple

If eligible, you can enroll in the Kaiser Permanente TRICARE Prime option during TRICARE Open Season, November 9 – December 14, 2020 or up to 90 days after a Qualifying Life Event (QLE). From enrolling to getting started after you’ve enrolled, we help make it simple to switch.

Costs and coverage

Your costs and coverage are the same as TRICARE Prime.

In addition, you’ll benefit from:

  • $0 annual enrollment fee for the 1st year. (After the 1st year the annual enrollment fee will be the same as TRICARE Prime.)
  • No-cost phone and video appointments, e-visits, and emailing your doctor
  • Up to $400 per household in wellness rewards
  • Discounts on acupuncture, chiropractic, and message therapy
  • No-cost telephone health coaching
  • Free online health programs and tools
  • Free or low-cost, in-person health classes
  • Special rates on gym memberships and discounts on health and fitness products
  • A free app to schedule appointments, refill prescriptions, view your medical record, and more.

Active-duty family members pay no enrollment fees or out-of-pocket costs for any type of care received through the Kaiser Permanente provider network.

For details on TRICARE Prime benefits, and costs, including copayments and enrollment fees, visit tricare.mil/costs/compare. external link.

Pharmacies and medications

Prescription coverage is included in your plan and you can get prescriptions filled:

  • at any of our 24 pharmacies located in each of our metro Atlanta facilities except the Southwood Specialty Center.
  • through mail order (including a 90-day supply refilled at a reduced copay) and have them delivered right to your home with no cost for shipping.

To review what drugs are covered, press “Ctrl” or “CMD” and “F” on your keyboard at the same time to search after clicking on our formulary. external link PDF. For questions about specific drug costs, call us at 1-877-904-0015.

Learn how we can help you transition your current prescriptions to Kaiser Permanente.