Travel Reimbursement Information Travel Reimbursement is for TRICARE Prime EnrolleesUnder provisions of the 2001 National Defense Authorization Act, TRICARE Prime beneficiaries referred by their primary care manager (PCM) for services at a location more than 100 miles (one way) from their PCM may be eligible to have their "reasonable travel expenses" reimbursed.Essential FormsITA Request WorksheetITA Traveler WorksheetTo qualify for medical travel reimbursement, the following applies:Must be enrolled to TRICARE Prime and must have a PCM at Fox Army Health Center. If the patient’s PCM is not at Fox, patient must contact TRO South Prime Travel at 1-800-554-2397 to be reimbursed for travel benefits.Patient must have an authorization from Humana (TRICARE)The specialty care provider’s office where the patient is being treated must be more than 100 miles (one way) from Fox Army Health Center.The following disqualifies a TRICARE Prime patient from travel reimbursement:If the patient elects to see a provider outside of the 100-mile radius from Fox when they were referred to a specialty provider within a 100-mile radius of Fox.If the reason for the appointment is not a benefit covered by TRICARE.If the patient does not request travel orders BEFORE the date of service to the specialty provider. Retroactive reimbursement is NOT authorized unless in cases of extreme emergency (i.e., the threat of or potential loss of life, limb or eyesight). In the event of an emergency, an oral travel order, conveyed by any medium, may be given. When this occurs, the Authorizing Official (AO) at Fox Army Health Center must promptly issue a confirmatory written travel order.To begin, complete and submit the attached Invitational Travel Authorization (ITA) Request Worksheet (ITA Request Worksheet) at least seven days BEFORE travel, to Ms. Karyn Wood, ITA Travel Coordinator. Ms. Wood is located near the Medical Records Department. If this is the first time you are requesting reimbursement, you will also need to complete and submit the Invitational Traveler (ITA) Worksheet (ITA Traveler Worksheet).Government rates will be used to estimate the reasonable cost. Beneficiaries are expected to use the least costly mode of transportation. The actual costs of lodging (including taxes and tips) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.For travel reimbursement, the patient must provide the following:Itemized food receipts dated on the appointment date or authorized travel dates. Alcoholic beverages are excluded from reimbursement.Lodging receipt (when applicable) must show a zero balance.Routing number and checking/savings account number (voided check) for electronic funds transfer. Parking receipts (when applicable), Valet Parking is not reimbursable A copy of the TRICARE Referral/Authorization A return to work/school slip, verifying appointment attendance with date and time Additional Guidelines can be found here ITA Information Sheet.**The patient is responsible for obtaining prior approval for lodging, rental car, or airfare.Non-Medical AttendantsA non-medical attendant (NMA) is a person who travels with a patient to a medical appointment for the purpose of attending to the needs of the patient due to age, physical or mental incapacity of the patient. A statement of medical necessity from the patient’s PCM is required before a patient is authorized the use of an NMA. One NMA is authorized per policy guidelines; no exceptions. Patients who are under 18 years of age do not require a statement of medical necessity from the PCM. The NMA must be a parent, guardian, or another adult family member of the traveling Prime patient. If the NMA is the parent or designated guardian, he/she is not required to be 21 years of age or older. If the NMA is an adult family member, the NMA must be 21 years of age or older. The NMA is NOT required to be enrolled in TRICARE Prime, or to be TRICARE eligible. Fox Army Health Center is responsible for issuing travel orders for the traveling Prime patient’s NMA. If the NMA is Active Duty or a DoD civilian employee, he/she is repaid for travel expenses based on temporary duty (TDY) rates (per diem and mileage), not actual expenses. The Active Duty NMA is responsible for obtaining travel orders from his/her unit Defense Travel System (DTS) point of contact. The Active Duty Soldier’s unit is responsible for initiating travel orders and reimbursement for an NMA who is active duty. Medical Travel for Patients Who Are Active Duty Service MembersActive duty service members (ADSM) are responsible for obtaining travel orders before their medical TDY travel. The ADSM will take their appointment slip to their unit DTS point of contact. The ADSM’s unit is responsible for initiating travel authorization in DTS. Fox Army Health Center will not reimburse ADSMs.Patients with questions regarding travel should contact: Ms. Karyn Wood, Invitational Travel Authorization (ITA) Coordinator at Fox Army Health Center, at (256) 955-8888, Extension 1616, or visit www.humana-military.com, or call 1-800-444-5445.