DD Form 2853 is the official TRICARE Plus Enrollment Application, managed by the Defense Health Agency (DHA). Completing and submitting this application gives eligible beneficiaries a designated Primary Care Manager (PCM) at their chosen Military Treatment Facility (MTF) and priority access to primary care appointments.
Who Is Eligible
TRICARE Plus enrollment is available to beneficiaries registered in the Defense Enrollment Eligibility Reporting System (DEERS) who are not currently enrolled in TRICARE Prime or another managed care option. Retired service members, their covered dependents, and survivors with both Medicare Part A and Part B may also qualify, provided their local MTF accepts TRICARE Plus enrollments.
What the Form Collects
The application gathers sponsor identification details including name, Social Security number, date of birth, and branch of service. It also collects mailing and residence addresses, the preferred MTF location, and primary care provider preferences for each enrolling family member. Section III requires the applicant's signature, confirming acknowledgment of program limitations and the responsibility to keep DEERS data current.
After You Submit
Return the completed original to the enrollment office at your chosen MTF. Processing typically takes a few business days, after which the facility will provide written confirmation. Note that TRICARE Plus does not cover specialty care - referrals outside the MTF require a TRICARE-authorized provider and standard cost-shares apply.
The current edition was revised in September 2024. The two-page PDF application is available from the Executive Services Directorate (ESD) and can be completed digitally with a free PDF editor or printed for manual completion.
| Question | Answer |
|---|---|
| Form Name | Dd Form 2853 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | dd2853 form, dd form 2853 fillable, tricare plus enrollment application, dd form 2853 feb 2014 |