TRICARE, Your Military Health Plan

In This Section:

• Beneficiary Web Enrollment
• Moving Made Easy for Active Duty Families
• TRICARE Prime
• Enrollment Access Standards
• Tips for Completing Your Enrollment Application
• Enrollment Deadlines
• Enrollment Fees
• Split Enrollment
• Disenrolling
• TRICARE Prime Remote
• Tips for Completing Your Enrollment Application
• Enrollment Deadlines
• Split Enrollment
• Disenrolling
• TRICARE Prime Overseas
• Split Enrollment
• Disenrolling
• TRICARE Prime Remote Overseas
• Split Enrollment
• Disenrolling
• TRICARE Reserve Select
• Monthly Premiums
• Terminating Coverage
• TRICARE Retired Reserve
• Monthly Premiums
• Terminating Coverage
• TRICARE Young Adult
• Changing Your Coverage Option
• Monthly Premiums
• Terminating Coverage
• US Family Health Plan
• Tips for Completing Your Enrollment Application
• Enrollment Deadlines
• Enrollment Fees
• Split Enrollment
• Disenrolling

Tips for Completing the Enrollment Application

1.  Fill out the enrollment application completely.

2.  You only need one enrollment application for your whole family unless you have more than three family members.  If so, you'll need more than one form.  Or, you can download just Section II (family member information page) of the TRICARE Prime Enrollment Application and PCM Change Form.

3.  When selecting your primary care manager (PCM):

• If you are choosing a network PCM, contact the provider's office to make sure the provider is accepting new patients.
• Select a PCM for each family member listed on your enrollment form.
• If a network PCM is not available in your remote location, you will not fill in this section.
  • You may select any TRICARE-authorized provider as your PCM.
  • Your regional contractor can assist you in finding an approved TRICARE-authorized provider

4.  If any family member is entitled to Medicare Part A:

• Fill out Section III.
• Include a copy of the Medicare card.

5.  Sign and date the application.

Last Modified:May 24, 2012