Birth or Adoption
TRICARE Prime parents have
60 days from date of birth or adoption of TRICARE-eligible children
to enroll them in TRICARE Prime to avoid delays or gaps in processing health
care authorizations and claims. This also prevents higher out-of-pocket
expenses for new parents. On the 61
st day, the child is
automatically enrolled in TRICARE Standard.
New Child Checklist:
- Enroll Your
Child in DEERS by submitting the following to the nearest ID card-issuing facility:
- Completed
DD
Form 1172
(Application for Uniformed Services Identification Card and DEERS
enrollment). This form must be notarized if the new enrollee does not
reside with the sponsor.
- An
original or certified-copy of a birth certificate or certificate of live
birth (signed by the attending physician or other responsible person from
a U.S hospital or military treatment facility) or consular report of
birth for children overseas.
- A
record of adoption or a letter of placement of the child into the home by
a recognized placement/adoption agency or the court before the final
adoption.
- Apply for a
Social Security Number (SSN) for your child by visiting www.ssa.gov or by calling 1-800-772-1213. Once
you receive your child’s SSN, visit your nearest ID card-issuing facility to
update their DEERS information.
- Enroll
Prime-Eligible Children in TRICARE Prime.
- Complete
the TRICARE
Prime Enrollment Application and PCM Change Form.
You may download and print this form or call 1-888-TRIWEST (874-9378)
to request one be mailed to you. You may also visit your local TRICARE Service Center
to pick one up.
- Sign
and date the form in either blue or black ink. Forms that are not signed and dated will be considered incomplete
and will be returned to you, delaying enrollment and coverage.
- Mail
the form with your enrollment fee for retirees with Prime Coverage (annual family enrollment is $460) to:
TriWest Healthcare Alliance
P.O. Box 43590
Phoenix, AZ 85080-3590