DD Form 2853: TRICARE Plus Enrollment Application

DD Form 2853 PDF Details

Submit completed application to the MTF where you are requesting enrollment. Each MTF has local policies for processing your application.

Sponsor information: Section I must be completed on all applications.

DEERS: ensure personal information matches information in the Defense Enrollment Eligibility Reporting System (DEERS).

Access: enrollment in TRICARE Plus does not guarantee access to services at the MTF.

Provider: if you are accepted for enrollment you will be assigned to a primary care provider at the MTF.

Primary care: beneficiaries enrolled into TRICARE Plus agree to rely on their MTF primary care provider for all their non-emergency primary care.

Section III: sign and date the application.