TRICARE Operations Manual 6010.59-M

Each TRICARE Manual on the web incorporates all changes by the date of publication. Although changes are published, they may not be implemented by the contractor until directed to do so by the Contracting Officer.
The TRICARE Operations Manual (TOM) is incorporated by reference into the Managed Care Support Contracts (MCSCs) and is the primary vehicle for operational guidelines and instructions to the contractor. The TOM provides a mechanism for clarifying and modifying existing contractual requirements, adding new specifications/requirements and deleting obsolete information. All or portions of the TOM may also be incorporated by reference into other TRICARE contracts.

April 1, 2015 edition

These manuals are applicable to the East and West Regional Managed Care Support Contracts awarded on or after 07/21/2016. Upon direction of the Contracting Officer, all or portions of these manuals may also apply to the TRICARE Quality Monitoring Contract (TQMC), TRICARE Claims Audit Review Services (TCARS), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm), TRICARE Dental Program (TDP), and TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC).
The April 1, 2015 edition of the TRICARE Operations Manual (TOM), 6010.59-M, is available online.
All future changes will be published to this edition.
Last Updated: October 27, 2020
Most Recent Change Number: Change 79


Page Count: 1,138
Summary of Changes: The 2017 National Defense Authorization Act (NDAA), Section 701 requires the Department of Defense to replace TRICARE Extra and Standard with a new healthcare plan called TRICARE Select as of January 1, 2018. Continuous enrollment will shift to an open season, similar to Medicare. The enrollment year will based on a calendar year versus a fiscal year. Beneficiary fees will be calculated based on when the sponsors initial period of service (before January 1, 2018 or on or after January 1, 2018). This change is published in conjunction with Apr 2015 TPM Change 9, Apr 2015 TRM Change 6, and Apr 2015 TSM Change 4.