health-forms-and-downloads - young adult dependent eligibility enrollment form

Category

young adult dependent eligibility enrollment form


Aug 09, 2019 · TRICARE Young Adult TRICARE Young Adult is a premium-based health care plan that adult dependent children who qualify can purchase. If you qualify, you have four ways to purchase TRICARE Young Adult: Online: Mailing addresses and fax numbers are found on the form.

Young adults must show eligible in the Defense Enrollment Eligibility Reporting System (DEERS) to enroll in TYA. Eligibility is established by your uniformed service sponsor. You may purchase TYA coverage if you: are a dependent of an eligible uniformed service sponsor (see note below).

TRICARE Young Adult is a plan that qualified adult children can purchase after eligibility for "regular" TRICARE coverage ends at age 21 Fax your enrollment form to your regional contractor ; Mail your enrollment form to your regional contractor >>Visit the TRICARE Young Adult Enrollment .

Young Adult Dependent Through Age 29 Certification Form. • For an election made during the required open enrollment period, after a change in Subscriber And Dependent Information, Eligibility Information, Acknowledgement And Signature, Young Adult Eligibility Certification Form, Notice Of Nondiscrimination, Excellus Blue Cross Blue.