Home
Forms Library
Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha

Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha 2025

Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha Preview on Page 1

See details

4.1 out of 5

47 votes

The document is a TRICARE Prime Select RCC/EFT Start or Change Form, intended for users to initiate or modify electronic payments for their monthly enrollment fees starting January 1, 2025. It includes sections for sponsor information, payment authorization, and privacy statements regarding the use of personal data by TriWest Healthcare Alliance.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to modify Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha in PDF format online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Handling documents with our comprehensive and user-friendly PDF editor is easy. Follow the instructions below to complete Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha online quickly and easily:

Log in to your account. Log in with your email and password or register a free account to try the product prior to upgrading the subscription.
Upload a document. Drag and drop the file from your device or import it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
Edit Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha. Quickly add and underline text, insert pictures, checkmarks, and symbols, drop new fillable fields, and rearrange or delete pages from your document.
Get the Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha accomplished. Download your modified document, export it to the cloud, print it from the editor, or share it with other people using a Shareable link or as an email attachment.

Make the most of DocHub, one of the most easy-to-use editors to quickly manage your documentation online!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the difference between TRICARE Prime and TRICARE Select?

Out-of-pocket costs with TRICARE Prime In general, TRICARE Prime has lower out-of-pocket costs than TRICARE Select. What costs can you expect? ADSMs, ADFMs, and transitional survivors have no enrollment costs. Retirees, their families, and others pay yearly enrollment fees.

How do you pay for TRICARE Reserve Select?

After your first premium payment, you must pay your premiums by automatic payment. You can set up an electronic funds transfer or use your debit or credit card. View TRICARE Reserve Select monthly premiums.

How to set up payment for TRICARE?

You have three options. Option 1: Set up automatic payments securely online. Option 2: Call 888-TRIWEST (874-9378) to pay through the automated phone payment system. Option 3: Download the Automatic Monthly TRICARE Payment Set Up Request form.

What does TRICARE Select Reserve cover?

How TRS works: TRICARE Reserve Select is a PPO-style plan that provides comprehensive, worldwide coverage for doctor visits, hospitalization, tests, and prescriptions. Unlike plans for active-duty members, you must pay a monthly premium for coverage, and there are out-of-pocket copay, cost-share, and deductible costs.

How to set up recurring payments with TRICARE?

Sign Up for Automatic Payments Option 1: Set up automatic payments securely online. Option 2: Call 888-TRIWEST (874-9378) to pay through the automated phone payment system. Option 3: Download the Automatic Monthly TRICARE Payment Set Up Request form.

How do I pay my TRICARE Reserve Select?

After your first premium payment, you must pay your premiums by automatic payment. You can set up an electronic funds transfer or use your debit or credit card.

Is TRICARE Reserve Select the same as TRICARE Prime?

2025 Monthly Premium 2025 Monthly Premium Member Only $53.80 Member and Family $274.48

Tricare Prime select reserve Recurring Credit Card (rcc) electronic Fund Transfer (eft) Start or Cha 2025

Here's how it works