Dd Form 2947 – Fill Out and Use This PDF

Dd Form 2947 PDF Details

The DD 2947 is the official TRICARE Young Adult (TYA) Application issued by the Department of Defense (DoD). Young adult dependents use this application to request enrollment in TRICARE Young Adult, a voluntary premium-based health plan covering unmarried dependents between ages 21 and 26 who are not eligible for employer-sponsored health insurance.

Who needs to complete this TYA application?

• Children of active duty service members who aged out of standard TRICARE coverage at 21
• Dependents of National Guard and Reserve members when a qualifying period of federal service ends
• Children of retired military personnel seeking continued coverage up to age 26
• Young adults who lost employer-sponsored insurance and want to enroll in TYA

Key information on the form

The application collects the sponsor's Social Security Number (SSN), rank, branch of service, and Primary Care Manager (PCM) assignment. Applicants select a plan option: TYA Prime (MTF-based primary care with capacity restrictions) or TYA Select (civilian TRICARE network via TriWest or Humana). Coverage requires monthly premium payments.

Related forms: For survivor benefits see DD Form 2656. For medical records release see DD Form 2870. Other TRICARE enrollment forms include DD Form 2946 and DD Form 2948. For civilian military health plans see United Healthcare Military.