Get the free AFTEA TRICARE Prime Supplement Plan - AFTEA Insurance Program

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AFTER TRI CARE Prime Supplement Plan ENROLLMENT FORMUnderwritten by: Transamerica Financial Life Insurance CompanyHome Office: 440 Mamaroneck Avenue, Harrison, New York, 10528, a Transamerica CompanyPolicyholder:

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How to fill out aftea tricare prime supplement

01

Gather your personal information such as full name, date of birth, and Social Security number.

02

Obtain a copy of the TRICARE Prime supplement form, also known as AFTEA Form 29-5796.

03

Fill out your personal information in section 1 of the form.

04

Indicate your TRICARE enrollment information in section 2.

05

Provide information about any other health insurance coverage you may have in section 3.

06

If you are authorizing direct payment to a provider, provide their information in section 4.

07

If you have any dependent children, provide their information in section 5.

08

Sign and date the form in section 6.

09

Make a copy of the completed form for your records.

10

Submit the filled out form by mail or fax according to the instructions provided.

Who needs aftea tricare prime supplement?

01

Anyone who is eligible for TRICARE Prime and wants additional coverage for out-of-pocket costs may need AFTEA TRICARE Prime supplement.

02

This includes military retirees, their family members, and survivors who are enrolled in TRICARE Prime, TRICARE Prime Remote, or TRICARE Young Adult-Prime.

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What is aftea tricare prime supplement?

AFTEA Tricare Prime Supplement is an additional form that must be submitted along with regular Tricare Prime enrollment to provide supplementary information for coverage.

Who is required to file aftea tricare prime supplement?

All Tricare Prime beneficiaries are required to file the AFTEA Tricare Prime Supplement form.

How to fill out aftea tricare prime supplement?

You can fill out the AFTEA Tricare Prime Supplement form online or by contacting the Tricare customer service for assistance.

What is the purpose of aftea tricare prime supplement?

The purpose of AFTEA Tricare Prime Supplement is to gather additional information needed to process Tricare Prime enrollment and provide accurate coverage.

What information must be reported on aftea tricare prime supplement?

The AFTEA Tricare Prime Supplement form requires information such as personal details, medical history, and any additional health insurance coverage.

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