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  • Prime Travel Patient Information Form - Tricare - Tricare

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PRIME TRAVEL PATIENT INFORMATION FORM TRICARE Regional Office - South 7800 IH-10 West Suite 400 Beginning Jan 1 2013 this form MUST accompany all claims or the claim will be held until San Antonio TX 78236 Phone 800 576-0375 the form is received. Please help us expedite your payment by sending in a complete claim pkg.

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You must present your uniformed services ID card as proof of eligibility. Your provider can check to confirm you have coverage under a TRICARE plan.

DoD Benefits Number (DBN) – an 11-digit number that relates to TRICARE benefit eligibility. This number is located on the back of the card at the top, next to the date of birth. The DBN (or the sponsor's SSN) must be used to verify TRICARE eligibility and when submitting TRICARE claims.

A Department of Defense (DoD) Identification Card is used to show your military status and to get access to services at military bases. You may also use this card to get discounts offered to Veterans at many stores, businesses, and restaurants.

The CAC, a "smart" card about the size of a credit card, is the standard identification for active duty uniformed Service personnel, Selected Reserve, DoD civilian employees, and eligible contractor personnel.

Every DoD ID card will have a DoD ID Number printed on it. Dependent ID cards will not have the DoD ID Number of their sponsor, just their own number. The DoD ID Number is not used for TRICARE.

Department of Defense (DoD) Benefits Number The DoD Benefits Number (DBN) is an 11-digit number on the back of the ID card.

The military ID card doubles as a health insurance card. On the back is the Tricare beneficiary's benefits number and confirmation that the holder has access to military treatment facilities and civilian health care if the word "YES" appears under both the words "Medical" and "Civilian."

Online Request Log in to milConnect. Click on the “Obtain proof of health coverage” button. Or click on Correspondence/Documentation and choose "Proof of Coverage." Your coverage letter will be generated and available for download.

What is the Prime Travel Benefit? The Prime Travel Benefit reimburses reasonable travel expenses. This includes mileage, meals, tolls, parking, lodging, local transportation, and tickets for public transportation. for a qualified trip by a TRICARE Prime enrollee.

If you're on active duty, you have to enroll in TRICARE Prime. All others can choose to enroll in TRICARE Prime or TRICARE Select. TRICARE Prime offers fewer out-of-pocket costs than TRICARE Select, but less freedom of choice for providers.

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© Copyright 1997-2025
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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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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