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  • Dd Form 2853 Feb 2014

Get Dd Form 2853 Feb 2014

TRICARE PLUS ENROLLMENT APPLICATION (Read Agency Disclosure Notice, Privacy Act Statement, and Instructions before completing form.) OMB No. 0720-0028 OMB approval expires Feb 28, 2017 AGENCY DISCLOSURE.

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Who can enroll? You may be eligible to enroll in TRICARE Plus if you're: TRICARE-eligible and not enrolled in a TRICARE Prime Plan, the US Family Health Plan, or a civilian or Medicare Health Maintenance Organization. A dependent parent or parent-in-law.

In general, TRICARE excludes services and supplies that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness (including mental disorder), injury, or for the diagnosis and treatment of pregnancy or well-child care.

There are four types of TRICARE Plus health plan options available overseas: TRICARE Plus – with Direct Care Only. TRICARE Plus – with TRICARE For Life. TRICARE Plus – with Active Duty Select.

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. If you have other health insurance. TRICARE supplements don't qualify as "other health insurance.", TRICARE Prime might not be right for you.

DD Form 2853, "TRICARE PLUS ENROLLMENT APPLICATION"

Those eligible for TRICARE include: Active duty service members and families. National Guard/Reserve members and families. Retired service members and families. Retired Reserve members and families. Beneficiaries eligible for TRICARE and Medicare. Survivors. Children. Former spouses.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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