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b
y CiCi Moore, TriWest Healthcare Alliance
9/7/2007 -
PHOENIX
-- New parents have 60 days from the date of birth or adoption to enroll their new child in TriCare Prime. Otherwise, on the 61st day, the child will be covered by TriCare Standard.
TriCare beneficiaries should follow these two steps for Prime enrollment:
Step 1 - Enroll Child in DEERS
To register a new child in the Defense Enrollment Eligibility Reporting System, obtain a copy of:
· The child's birth certificate;
OR
· Certificate of live birth;
OR
· Adoption papers;
AND
· Complete a Department of Defense Form 1172, "Application for Uniformed Services Identification Card and DEERS Enrollment." This form should be notarized if the new enrollee does not live with the sponsor.
File these forms with the base personnel office. If the sponsor is deployed or TDY, the other parent or guardian should be prepared to show power of attorney to register the child.
Step 2 - Enroll Child in TRICARE Prime
Once the child is enrolled in DEERS, he or she can be enrolled in Prime. Parents should complete a DD Form 2876, "TriCare Prime Enrollment Application and PCM Change Form," for the new child.
Select the first and second preference for a Primary Care Manager, as final PCM assignment is dependent upon provider availability and local Military Treatment Facility policy.
Active-duty family members who would like to receive medical care from an MTF should contact the Managed Care Office at their MTF or TriCare Service Center before submitting the enrollment application. MTF provider assignments are coordinated by the Managed Care Office at the MTF or through the local TSC. MTF providers are not listed in the online Provider Directory.
Sign and date the form in either blue or black ink. Forms that are not signed and dated are considered incomplete and will be returned, delaying the enrollment process. Mail the complete form to:
TriWest Healthcare Alliance
P.O. Box 41520
Phoenix, AZ 85080-1520
Beneficiaries who have questions or need more information on Prime enrollment should visit the beneficiary services section of
http://www.triwest.com/
or call 1-888-874-9378.
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