Get Uhc Reinstatement Email Form

Filling out the Uhc Reinstatement Email Form online is essential for individuals seeking to either reinstate or reenroll in their TRICARE coverage. This guide provides a clear and supportive walkthrough of the form, helping users understand each section and complete it accurately.

Follow the steps to fill out the Uhc Reinstatement Email Form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your document editor.
2. Select the appropriate coverage type by checking the corresponding box for either Prime, TYA (Young Adult), TPR (Prime Remote), or TRR (Retired Reserve) in the coverage section.
3. Enter the sponsor's name, home address, email address, and Social Security Number or Department of Defense Benefit Number in the fields provided. Ensure all information is accurate and clearly printed.
4. In Step 1, indicate the action you are requesting by checking one of the three options: 'Please Reinstate coverage,' 'Please Reenroll coverage,' or 'Please Retroactively Enroll coverage.' Carefully read the descriptions associated with each option.
5. For Step 2, provide a detailed explanation of the reason for your request, and list each individual to be reenrolled or reinstated, ensuring to include any necessary details.
6. In Step 3, gather and provide any supporting documentation that is relevant to your request, such as proof of payment or fax confirmation.
7. Sign the request form in Step 4. Note that the request will not be processed without your signature.
8. In Step 5, submit the form by either mailing it to the provided address or faxing it to the designated number.

Take the necessary steps to complete your documents online and ensure your coverage needs are met.