Tricare humana east 2025

1. Click ‘Get Form’ to open the TRICARE Other Health Insurance Questionnaire in the editor.
2. Begin by filling in the TRICARE Sponsor Name and either the Sponsor’s Social Security Number or Department of Defense Benefits Number. Ensure accuracy as this information is crucial for processing your claims.
3. Indicate whether you or any family members currently have Other Health Insurance (OHI) coverage by selecting ‘Yes’ or ‘No’. If applicable, complete the remaining sections of the form.
4. In the Primary OHI Status section, provide details such as Policy Holder Name, Policy Number, and Group/Plan Number. This information can typically be found on your insurance card.
5. Continue filling out additional fields regarding pharmacy benefits, exclusions, and covered members' details including their names, IDs, dates of birth, and effective dates.
6. If you have more than one OHI policy, replicate the process in the Additional OHI Status section. For prior OHI status within the last 12 months, follow similar instructions as above.
7. Finally, read through the consent information carefully. Sign your name, indicate your relationship to the sponsor, and date the form before submission.

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