How do you plan to pay?
If using insurance: carrier name, member ID, and the insured's full name and date of birth if the plan is under someone else (a spouse, parent, or sponsor). Then upload the front and back of your card below. Complete inquiries are reviewed and responded to first. Inquiries with missing information are set aside until we receive the missing details, which can add significant time
Limited to 600 characters
Upload a photo of your insurance card
TRICARE verifies coverage through the service member's information, so we need the sponsor's SSN or the DoD Benefits Number from the back of your card. This form is HIPAA secure, and we only use it to verify your benefits.
For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.