Get Ndta Tricare Supplement Plan

Filling out the NDTA TRICARE Supplement Plan online can seem overwhelming, but this guide will help you navigate the process with ease. By following the steps outlined here, you will be equipped to complete the enrollment form accurately and efficiently.

Follow the steps to fill out the form with confidence.

1. Click ‘Get Form’ button to access the enrollment form and open it in your online editor.
2. Provide your personal details in the required fields. Enter your first name, last name, group policy number, branch of service, member number (if applicable), rank or grade, date of birth, home phone number, and address including city, state, and zip code.
3. If you would like coverage for your spouse and/or children, complete the designated section. Fill in your spouse's full name, and their date of birth, and list your children's names and birth dates as applicable.
4. Indicate whether you are currently enrolled in CHAMPVA by checking 'Yes' or 'No' as required. Ensure that you mark the appropriate boxes for any coverage options you desire for yourself and your family members.
5. Select your monthly premium rate based on the plan you choose. Check the corresponding box for the age category that applies to you and your spouse, in addition to all child selections.
6. Choose your preferred payment method by selecting from the options provided: monthly, quarterly, semi-annually, or annually. If you opt for Electronic Funds Transfer (EFT), remember to include two months' premium as your initial payment.
7. If you or your spouse are users of TRICARE Prime, check the corresponding box to receive additional information about the NDTA TRICARE Prime Supplement Insurance Plan.
8. Review your completed form carefully. Sign the document, noting the date, and ensuring that your spouse also signs if they are applying for coverage. Make sure to attach any required documentation including a voided blank check if opting for EFT.
9. Save your final changes to the form. Once completed, download, print, or share the form as needed to ensure it is submitted with your initial premium payment.

Complete your NDTA TRICARE Supplement Plan enrollment online today for comprehensive coverage.