Get Us Army Tricare Insurance Form

This guide provides step-by-step instructions for completing the Us Army Tricare Insurance Form online. Whether you are a new applicant or making changes to your existing coverage, our comprehensive instructions will help you navigate each section with confidence.

Follow the steps to complete your Tricare Insurance Form online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Complete the member’s information section, including your last name, first name, initial, street address, date of birth, and military rank and service information.
3. Select the appropriate box to indicate your status as either retired, widow(er), or a member of the Temporary Retired Reserve (TRR). Include your military retirement date.
4. Fill out the dependent information for each individual you wish to enroll under the plan, detailing their names, genders, and dates of birth.
5. Choose the coverage you wish to request by selecting from the available options, such as the High Option II Retiree Plan for yourself, your spouse, or your children.
6. Indicate the amount you are enclosing for the first quarter’s payment and ensure to double-check the premium schedule in the brochure.
7. Read and acknowledge the statements regarding coverage and fraud, ensuring to include your member’s signature, spouse’s signature (if applicable), and the date.
8. If opting for the Checkomatic payment plan, complete the Checkomatic form on the reverse side, providing your bank details and signing for authorization.
9. Once all required fields are filled, review your entries for accuracy, then save changes, and proceed to download, print, or share the completed form as needed.

Complete your Us Army Tricare Insurance Form online today to ensure your coverage needs are met.