DD Form 2853 is the two-page TRICARE Plus Enrollment Application used by eligible military beneficiaries to enroll in primary care at a Military Treatment Facility (MTF). Understanding each section of this enrollment application before you start helps you complete the form accurately and avoid delays in processing.
Who Can Use DD Form 2853
You may use the DD Form 2853 enrollment application if you meet all of the following requirements:
- You are registered in the Defense Enrollment Eligibility Reporting System (DEERS)
- You are not currently enrolled in TRICARE Prime, TRICARE Prime Remote, or another TRICARE managed care option
- Your local MTF offers TRICARE Plus enrollment and has open slots for primary care
- You are a TRICARE-eligible beneficiary (active duty family member, retiree, dependent, or survivor)
Contact your local MTF enrollment office to confirm availability before completing the application. TRICARE Plus enrollment slots are limited by facility capacity.
Sections of DD Form 2853
The application form is organized into three main sections:
- Section I - Sponsor Data: Enter the military sponsor's name, Social Security number, date of birth, rank, component, and branch of service.
- Section II - Beneficiary Data: Provide the name, date of birth, mailing address, residence address, telephone number, and preferred MTF for each family member enrolling in TRICARE Plus.
- Section III - Signature Block: The applicant signs and dates this section, confirming enrollment intent and acknowledging that TRICARE Plus does not include specialty care coverage outside the MTF.
How to Fill Out DD Form 2853 Online
With FormsPal's online PDF editor, you can complete or edit the tricare plus enrollment application right here and now. We are committed to providing you with the best experience with our tool by continuously releasing new features and enhancements. All it requires is a couple of easy steps:
Step 1: Access the PDF inside our tool by clicking the "Get Form Button" at the top of this page.
Step 2: Using our online PDF editor, it is possible to accomplish more than merely complete forms. Edit away and make your forms look sublime with customized text added, or adjust the original content to excellence - all accompanied by an ability to incorporate stunning graphics and sign it off.
With regards to the blanks of this particular PDF, here is what you should know:
1. The tricare plus enrollment application needs particular details to be typed in. Ensure that the next blank fields are completed:
2. After the last array of fields is complete, you are ready to put in the essential particulars in Enrolling Family Members a Name, b Date of Birth YYYYMMDD, c Mailing Address StreetPO Box, d Residence Address If different, X if same as sponsor, e Telephone Number Include area, Home, Second Choice, X if same as sponsor Work, X if under the care of this, X if under the care of this, For Government Use Only, SECTION III SIGNATURE, and I understand that TRICARE Plus in order to move on to the next stage.
3. The following step is focused on I understand that TRICARE Plus, b Date Signed YYYYMMDD, and Return ORIGINAL completed form to - type in each one of these fields.
You can certainly get it wrong when filling out your Return ORIGINAL completed form to, so make sure to reread it prior to when you submit it.
Step 3: Make sure your details are correct and then click "Done" to proceed further. Join FormsPal now and instantly obtain the tricare plus enrollment application, all set for download. All alterations you make are preserved, which means you can modify the form further if needed. We do not sell or share any information that you enter while completing forms at our website.
Common Errors to Avoid
- Outdated DEERS records: Update your DEERS registration before submitting. If your address or dependency status has changed, DEERS must reflect the current data or your enrollment may be delayed.
- Incomplete beneficiary section: Each family member who wants to enroll requires their own complete entry in Section II. Do not leave date of birth, address, or telephone number blank.
- Using an older form edition: Always use the September 2024 or later edition. Submitting an outdated PDF version may cause processing delays.
- Missing signature: Section III must be signed and dated. An unsigned application cannot be processed by the MTF enrollment office.
- Wrong MTF selection: Confirm that your chosen MTF has open TRICARE Plus enrollment before submitting. Select an alternative facility if your first choice has no availability.
Where to Submit the Completed Form
Return the original completed enrollment form to the enrollment office at your preferred MTF. The facility will process the application and send written confirmation once enrollment is active. You can find TRICARE Plus accepting facilities through the official TRICARE enrollment page. Retain a signed copy for your personal records and keep your DEERS information current for compliance purposes.
Related TRICARE and Military Health Forms
If you work with TRICARE benefits or other military health paperwork, you may also need these related forms:
- TRICARE RTC Application - for enrollment in TRICARE Reserve Select or Reserve Component health plans
- EFT Form TRICARE West - for setting up electronic funds transfer payments in the TRICARE West region
- TRICARE LOR Form - a letter of referral used when requesting specialty care under TRICARE
- Military Dependent Form - used to add or update dependent information in military benefit programs
- DD Form 2656 - Data for Payment of Retired Personnel, used alongside enrollment forms for retiree benefit setup