Dd form 2947 2011-2026

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30 votes

The document is a TRICARE Young Adult Application form, which allows certain former military health care beneficiaries to apply for extended dependent health care coverage under the TRICARE Young Adult Program. It outlines the necessary information required for application, including personal details, coverage options, and payment methods. The program provides medical coverage for unmarried dependents aged 21 to 26 who are not eligible for employer-sponsored health plans.

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Click ‘Get Form’ to open the dd form 2947 2011 in the editor.
Begin by selecting the TRICARE coverage desired in Section 1. Choose one option that best fits your situation, such as TRICARE Standard or TRICARE Prime.
In Section 2, indicate your requested action by checking the appropriate box. This could be starting coverage, terminating it, or transferring to another plan.
Fill out your personal information in the Applicant Information section (Sections 4-10). Ensure accuracy when entering your name, Social Security Number, date of birth, and contact details.
Complete Section 11 if you have a preference for a Primary Care Manager (PCM). Provide their name and address if applicable.
In Sections 12-16, provide details about the Uniformed Services sponsor and select your premium payment method. Make sure to include all necessary financial information.
Finally, sign and date the application in Section 17 to certify that all information is accurate before submitting it through our platform.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (120 Votes)
2016	4.2 Satisfied (56 Votes)
2012	4.3 Satisfied (116 Votes)
2011	4 Satisfied (30 Votes)

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