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Get Tricare Other Health Insurance Coverage Questionnaire 2012-2024

Mber or Sponsor Department of Defense Benefits Number: Do you or any of your family members currently have other health insurance (OHI) coverage? Have you or any of your family members had OHI coverage in the past 12 months? Yes Yes No No If you answered yes to either question above, please complete the remainder of the questionnaire (duplicate questionnaire for multiple policies). Regardless of your answers above, please read and sign the questionnaire at the bottom an.

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