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OEDIPUS TRI CARE RETIRED RESERVE SUPPLEMENT INSURANCE PLAN ACTIVATION FORMAGP5889 096342021010 04089QComplete all information in ink.1Please complete the following information. Endorsed by:NOTE: Name
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Fill out the personal information section with your full name, date of birth, and contact information.
02
Provide information about your military service such as your branch, rank, and dates of service.
03
Include details about any other health insurance you have, including Medicare or employer-sponsored plans.
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Sign and date the form to certify that the information you provided is accurate.

Who needs mediplus tricare retired reserve?

01
Individuals who are retired members of the National Guard or Reserves and are eligible for TRICARE Retired Reserve benefits.
02
Those who are looking for supplemental health coverage in addition to their TRICARE benefits.
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Mediplus Tricare Retired Reserve is a supplemental insurance plan for military retirees.
Military retirees who are enrolled in Tricare Retired Reserve may be required to file for Mediplus Tricare Retired Reserve.
To fill out Mediplus Tricare Retired Reserve, retirees can visit the official website of the insurance provider or contact their customer service for assistance.
The purpose of Mediplus Tricare Retired Reserve is to provide additional coverage and benefits for military retirees beyond what is offered by Tricare Retired Reserve.
Information such as personal details, medical history, and coverage options may need to be reported on Mediplus Tricare Retired Reserve.
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