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Benefit Information
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TRICARE PRIME
Under TRICARE Prime, immunizations are covered under clinical preventive services. The TRICARE benefit has a new recommendation that annual vaccinations should be administered to all children aged 5 to 18 years, beginning in the 2008-09 influenza season, if feasible, but no later than the 2009-10 influenza season. As part of TRICARE Prime’s enhanced benefit, you can go to any network provider without a referral for clinical preventive services and well-child services and pay nothing out of pocket.
Active Duty Family Members (ADFM)
Immunizations for active duty family members whose sponsors have permanent change of station orders to overseas locations also are covered. If these immunizations for overseas travel are received in the MTF they are at no cost to the beneficiary. ADFMs that need to go outside the MTF for an immunization and are TRICARE Prime have no co-payment. ADFMs who are not TRICARE Prime may either go to a network provider for their immunization and pay 15% of the contracted reimbursement rate or go to a provider that is not in the TRICARE network and pay 20% of the maximum allowable charge.
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