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
