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  • Email To Disenroll Tricare Overseas Form

Get Email To Disenroll Tricare Overseas Form

TRICARE PRIME DISENROLLMENT REQUEST AGENCY DISCLOSURE NOTICE Form Approved OMB No. 0720-0008 Jul 31, 2013 The public reporting burden for this collection of information is estimated to average 5 minutes.

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Voluntary Disenrollment Active duty service members can't disenroll from TRICARE Select. All others can choose to disenroll at anytime, but may be "locked out" from re-enrolling until the next open enrollment season.

“Certain events will cause you to be disenrolled from TRICARE Prime or TRICARE Select, like losing your eligibility, or not paying your enrollment fees,” said Mark Ellis, chief of the Policy and Programs Section of the TRICARE Health Plan at the Defense Health Agency.

You can disenroll from TRICARE Prime via: Web: Log into the Beneficiary Web Enrollment Portal. Phone: Call your regional contractor. East: 1-800-444-5445. West:1-844-866-9378. Overseas: Call the Regional Call Center for your overseas area. Mail: Download your region's disenrollment form: East Disenrollment Form.

Take the following actions to end your coverage: Log on to milConnect and follow the instructions to "Disenroll" Complete the Reserve Component Health Coverage Request Form (DD Form 2896-1) Print and mail your completed form to your regional contractor.

Sponsors or registered family members can make address changes, but only the sponsor can add or delete family members, and documentation is required. To update your DEERS information: Visit your personnel office or contact the Defense Manpower Data Center Support Office at 800-538-9552.

Component Health Coverage Request form (DD Form 2896-1) must be postmarked or received no later than 60 days after the date of the sponsor's passing. Premiums will be refunded if there have been no claims for health care submitted during this 60-day period.

Voluntarily End Coverage Log on to milConnect and follow the instructions to "Disenroll" Complete the Reserve Component Health Coverage Request Form (DD Form 2896-1) Print and mail your completed form to your regional contractor.

Toll-Free: 1-888-777-8343, option 3 (if calling from the U.S.)

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232