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The following is a list of forms available for download at any time. The documents on this page require Adobe Acrobat for viewing. Please download it here if you do not have the latest version.
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Beneficiaries should use this claim form to submit claims/bills for their healthcare. **If you are unable to open the form using the link please right click and select "Save link as." Once saved locally, you can open the form. (download file | 41 KB)
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If there has been a change or you have become eligible for insurance other than TRICARE For Life, you can submit the information using this questionnaire. (download file | 58 KB)
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Used to inform TRICARE For Life of the unfortunate passing of a loved one and to notify us who is handling the deceased estate. (download file | 68 KB)
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Used to explain situations in which the beneficiary's condition was the result of an accident or work related injury. **If you are unable to open the form using the link please right click and select "Save link as." Once saved locally, you can open the form. (download file | 1.34 MB)
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Provide authorization to an individual to release information protected under the Federal Privacy Act. This form is not valid to designate a representative for the Appeals process (there is a separate form in the forms list for the appeals process). (download file | 71 KB)
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Designates a representative for the Appeals process only. (download file | 86 KB)
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Needs to be submitted with a copy of the WPS Explanation of Benefits (EOB) to: WPS/TRICARE For Life P.O. Box 7928 Madison, WI 53707-7928. (download file | 80 KB)
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 1-check-claim-status | Check claim status | /wps/portal/tdb/tricare4u/home/quick-links/1-check-claim-status/!ut/p/z0/jY5JD4IwFIT_Ch48Nu8hxnhtNIoLbtGIvZjasFSwgBS3X69oPLglnl7mzWS-AQYuMMUPMuBaJorHN71ijfXEthu22cRhl3YQ6WI8G83p1MSBBX1gL4F2t4nUqWPPWVgWTsyyQW6zjFFgIlHaO2lwj2lu3IXShqeCWOZhFcsHF5oUeRX9ZL97nrKhtndaTgAs5TokUvkJuA_vHf-x7298VkgRGbFU0Q1sEhF6IiIi5nJHcs118WvH12gasc3Zugy9Ja1cAdt85_E!/ | /wps/portal/tdb/tricare4u/claim-activity/!ut/p/z0/jY7LDoIwFER_BRYsyS0gBJcNJoDShI0JdmMq4VHF8qrPr5dqTIxuXE1m7uTMBQoZUMHOvGKSt4I1k99Qb5tGkRdZPkp8FPoIe667ioO5jQMPlkA_C-FCFcgMxWTtOCi1FIHv-55ioHkrZHGVkF26UXsaIbVCVA0fawOpgOXSPI0GKtvh-BZFsAcSkApox2RtclG2kL1uX_O___0_3zA-AbsD3d2ce4Kxrj8AXUecOA!!/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | See if my claims have been processed and what I owe. | You must be logged in to your account to view your claims. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to login and view your claims. |
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| Jul 21, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 10-see-what-is-covered | See what is covered? | /wps/portal/tdb/tricare4u/home/quick-links/10-see-what-is-covered/!ut/p/z0/jY5Bb4JAFIT_Ch48bt6jGMJ100ZRwdpGU9xLs6ULrOAusCtaf71i00NtTHp6mTeT-QYYJMAU72TOrdSKVxe9Yf77Mgz90A0wmtAxIl0_vy5W9MXFuQczYL8CT5MAaTzCabz2PFy6fYPcNg2jwFKtrDhaSA61ca5CWUeovJKmGGL_4KklezPETLe7n9M3PLTxY5wDq7ktiFSZhuTbu8X_2fdvfLOXaelUUpUXsIvECEEOBbdEGpLqTrTi886SO-G6ZB9f3ikSb3RwBiMZI3Y!/ | /wps/portal/tdb/tricare4u/benefits/coverage-and-costs/!ut/p/z0/jU69DoIwGHwVHBzJV8EQHBsxIKEJiwa7mIoFq9gCrfjz9IrGQV2cLveTuwMKGVDJOlEyI5Rk1YOvqLdOo8iLRj5KQrKcIDwL4iD1kOv4DsRAPwJB6CNMxmhOFq6L0lHfIPZNQzHQXEnDLwayc62tJ5HG4rKshN4NUS-w3NgnPUSFao9v6BuclkxJCbRmZmcLWSjIXt73_M-_v-c3XPJCGN0f6XjLSm4zubVzpY2G-kA3V_eWYDwY3AFLEfMZ/ | Unauthenticated,Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | Find out what TRICARE For Life covers. | . |
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| Jul 21, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 11-download-a-form | Download a form | /wps/portal/tdb/tricare4u/home/quick-links/11-download-a-form/!ut/p/z0/jY5JD4IwFIT_Ch48Nu9VjPHaaBQX3KIRezEVESvYgtT11ysaD26Jp5d5M5lvgIMHXImDDIWRWon4pme8Mh84TsWhVew2WQORTfqj3pgNKXZsaAN_CdSbVWRuGVvuxLZxQPMGuUlTzoD7WpngZMA7Jpl1F8pYgQpjma2LmD-Eb8g-K-JK77bPkzeUdm7NDYEnwqyJVCsN3sN7x3_s-xuf7qUfWbFU0Q1MKVnqo4q1WBJBctSPFV-CScQXZ_vSDaascAXY_HFQ/ | /wps/portal/tdb/tricare4u/contact-us/forms/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8ziAzw8zDwMLQx83F3cLQwcfU0MPH1DjY0NAgz1vfSj8CsAmpCZVVgY5agflZyfV5JaUaIfUV5QrADm5JUopOal52QWZ6gagAQSk0t0S4tVDdLyi3KL9QuyoyIBeC5YZA!!/ | Unauthenticated,Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | View, download, or print the available TRICARE For Life forms. | . |
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| Jul 21, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 12-contact-customer-service | Contact customer service | /wps/portal/tdb/tricare4u/home/quick-links/12-contact-customer-service/!ut/p/z0/jY7NbsIwEIRfJRw4RrshCHG1qCD8hFIEavClMpYTTIKdxA60PD0ExAEQFafV7OzON0AhAqrYXibMSq1YdtYr2vmZBUEn8Lo4GZA-Ill-zqcL8uXh2IcR0LuDj0EXSdjGYbj0fZx5dYLcFgUlQLlWVvxaiA65cS5CWUeoJJNm08R6wbh1K9PEWJe726gTWmXYCxOgObMbV6pYQ3T1HvFP_d7GF5XkqZNJlZ7BXsu91eGVsXonSteIci-5eFHnv488pes__zgR36RxAvEbPGo!/ | /wps/portal/tdb/tricare4u/contact-us/contact-us/!ut/p/z0/nU7JDoIwFPwVOHAkrywhXBtNQEMTLib4LqYSKFVsWer69YLGKwdPk1kyM4BQACp-k4IbqRVvJ77H6JCnaZR6McmSdRITykKyYbsgIGEEW8CFQO7NDfLU90gBS61M9TBQ3LvR-hBlrEqJVo6NQ2aBl8a9jg6p9XD5wdzgD2zFBGDHTeNKVWsovt7y_PTvj3noznh8Bq-MUtt-AxrwzmI!/ | Unauthenticated,Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | There are several avenues available to contact us. | . |
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 2-view-my-explanation-of-benefits | View my Explanation of Benefits (EOB) View/ print my EOB | /wps/portal/tdb/tricare4u/home/quick-links/2-view-my-explanation-of-benefits/!ut/p/z0/jZBNT8JAEIb_Sj1w3MyUEsJ1I4GqVNFIKHshS7MtQ8tsS5fPXw-FeFBj8DR55-N93gwoiEGx3lGmHVnWxUXPVHc-DsNu6PdwNJQDRDl5-3j9lO8-vgTwDOrbQn_YQxl18CmaBAGO_caBVlWlJKjEsjMHB_G-rL2rYOcZzgqqly1sGjpxYlu3MLWb9VdpHNqb6DHKQJXaLQVxaiG-zX7if-X7N77aUpJ7BXF-AbfFjsxerI_CHMpC8_UdwqZiYdik5P4Kdf-uzNXiGJxGZiofznDr16E!/ | /wps/portal/tdb/tricare4u/claim-activity/!ut/p/z0/jY7LDoIwFER_BRYsyS0gBJcNJoDShI0JdmMq4VHF8qrPr5dqTIxuXE1m7uTMBQoZUMHOvGKSt4I1k99Qb5tGkRdZPkp8FPoIe667ioO5jQMPlkA_C-FCFcgMxWTtOCi1FIHv-55ioHkrZHGVkF26UXsaIbVCVA0fawOpgOXSPI0GKtvh-BZFsAcSkApox2RtclG2kL1uX_O___0_3zA-AbsD3d2ce4Kxrj8AXUecOA!!/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | View/ print my Explanation of Benefits (EOB). | You must be logged in to your account to view your EOB’s. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to login and view your EOB's. |
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 3-check-eligibility | Check eligibility | /wps/portal/tdb/tricare4u/home/quick-links/3-check-eligibility/!ut/p/z0/jY5Lb8IwEIT_SnrgGO0GV4irRQXhkQIVqMEXZCyTbOM6CTHPXw8p4kBLJU6r2RnNNyAgBmHljhLpKLfSXPRCtJaTMGyFQRtHPd5F5PPxx_uMTwMcMhiAuAu89drIo1fsR3PGcBLUDfRVloKDULl1-uAg3heV9yOs87RNDFVpA-uHVM7fVg1c55vv26kbmpuoEyUgCulSn-w6h_jq_cb_2fc0vtySyjxDNruAma9SrTJfG0poRYbc8Z8Zj5JFJlZHdhrpT_5yBiSwH2w!/ | /wps/portal/tdb/tricare4u/family-profile/family-profile/tricare-eligibility-and-costs/!ut/p/z0/jU7JbsIwEP0VOORojSGQpscIJMISiQsi9QWZ4IQBYwdnoA1f36ZVJQQCcRq9eSsISEEYecZCEloj9Q_-EMFqHsdB3An5LOSjkEdBvz8dD9670_gNJiCuBaNhI0h6fJwsfJ_PO00C7o5HEYHIrCH1RZB-llXrFxhqKVNorLYebx4yI3aqPJ5bd_g_TULXJYOkAFFK2jI0uYX0j7upv9_3cn0uD6hrVjqbo1YeJ4eZdIopjQWuUSPVTJoNy2xFjzY995R7sa79y0wto_Y3eZpYug!!/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | See if you or your family members are currently eligible. | You must be logged in to your account to view your eligibility information. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to login and view your eligibility information. |
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 4-view-deductible-and-other-costs | View deductible and other costs | /wps/portal/tdb/tricare4u/home/quick-links/4-view-deductible-and-other-costs/!ut/p/z0/jY7NTsNADIRfJRx6XNlpqqrXFYgGaKAgKsJequ1mm5iE3fw4LfD0NEUcACE4WeOx5xtQkIJyeke5ZvJOVwf9qKbrZRxP43CGi7k8R5Srm7vre3kb4lUEl6C-HJzNZyiTCV4kqyjCZTgk0FPTKAnKeMf2hSHd111wFI4D6_KKumKEw0IbFn03wq1vnz_HkDBuk9MkB1VrLgS5rYf0w_uO_9Hv3_imJ1MGFbnyAJ6IHdm9yGzWG6ZNZYV2mfBc2FYY3_Fvpf7-q0u1eY3eFvZBnrwD4rvEUg!!/ | /wps/portal/tdb/tricare4u/family-profile/family-profile/tricare-eligibility-and-costs/!ut/p/z0/jU7JbsIwEP0VOORojSGQpscIJMISiQsi9QWZ4IQBYwdnoA1f36ZVJQQCcRq9eSsISEEYecZCEloj9Q_-EMFqHsdB3An5LOSjkEdBvz8dD9670_gNJiCuBaNhI0h6fJwsfJ_PO00C7o5HEYHIrCH1RZB-llXrFxhqKVNorLYebx4yI3aqPJ5bd_g_TULXJYOkAFFK2jI0uYX0j7upv9_3cn0uD6hrVjqbo1YeJ4eZdIopjQWuUSPVTJoNy2xFjzY995R7sa79y0wto_Y3eZpYug!!/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | Sometimes deductible or other out of pocket expenses apply. Find out more… | You must be logged in to your account to view your eligibility information. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to login and view your expense and cost information. |
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 5-update-paperless-eob-option | Update paperless EOB option or personal information | /wps/portal/tdb/tricare4u/home/quick-links/5-update-paperless-eob-option/!ut/p/z0/jZDLbsIwEEV_JV2wtGZCALG1iiA8QmkFavAGmWCCSbCd2GmBry9p1UWLQKxGdx73XA0wiIEp_iFT7qRWPL_oJeusZmHYCf0uTga0j0gXL2_TOX31cRzACNifhd6gizRq4TBaBAHO_NpB7ouCUWCJVk4cHcSfxnrfQjlPqDSXdtfAusETRyrbwK0uD7-ldmiW0XOUAjPc7YhUWw3xz-w__irfw_iikknm5VJlF3CbVGbDnSCGG1Hmwloi9JpoU7_lRqD7NyZj61Nwnoh3-vQFMNcRWw!!/ | /wps/portal/tdb/tricare4u/family-profile/family-profile/my-personal-information/!ut/p/z0/jVDLDoIwEPwVPXAkW0ERj0QTUSTxYsReTCUFq9BCqQ_8einGxGhIPO3O7mRmMoAhAszJlaVEMcFJ1uAddvZr33f8gYtWLpq7yHNGo2AxnViBP4Yl4E_CfKYJ4RAtwo1to_VAK7BTWWIPcCy4oncF0a2oei3gqkd5mrHqaCB9ILEyL5WBEiHz99AKlgynYQq4IOpoMp4IiF6_L_vffH_bJyRnWW0WUiQsowbKm53KSrfQOsq87aQjTRe7OONDbT9WdOv1n4vR6C0!/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | Update address, contact information or paperless EOB option. | You must be logged in to your account to update your personal information. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to login and view your personal information. |
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 6-add-update-other-health-insurance | Add/update Other Health Insurance (OHI) | /wps/portal/tdb/tricare4u/home/quick-links/6-add-update-other-health-insurance/!ut/p/z0/jY7NbsIwEIRfJT1wtHZDUMTVoiopkBYQqKkvaJuYxCS18-PQwtNDQD20qBKn1ezszjcgIAKhaa9SsspoKs76XfibeRD4gTvE2Zg_IfL16_JlxRcuTj2YgPh18DgeIg8H-ByuPQ_nbpegdlUlOIjYaCu_LURfZeNchLaO1GmhmqyH3YJiy9qmh1tTf_6MLqFfh6MwBVGSzZjSWwPR1fuLv-l3N75qVZw7hdL5GewzShLWlglZyYzNZM0yScUF3rQ16Vj-U-uezzIXHwfvOJNv_OEES0Okzw!!/ | /wps/portal/tdb/tricare4u/family-profile/family-profile/insurance-coverage/!ut/p/z0/jY7LDoIwFER_BRcsya0iiEuCiSiSsDFiN6aSAlVooVR8fL2iMTE-Elc3c-dkZgBDDJiTlmVEMcFJcdNrbG8i37f9voMWDpo6yLUtK5h540Hgj2AO-BWYTjogHKJZuDRNFPW7BLara-wCTgRX9KQgPlaNdhdcaZRnBWtyHXUPkijj0OgoFbJ8ni5hIEMvzABXROUG46mA-OG91X_u-7s-JSUrzkYlRcoKqiPGm4MkPKFGIloqSUZ_DPkCVnu8PZuXBV25vSvlKPxR/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | Make sure all OHI information we have on file is correct. This is important to ensure we process your claims correctly! | You must be logged in to your account to update your OHI. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to login and view your personal information. |
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| Jul 20, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 7-submit-a-claim-send-or-check-secure-messages | Submit a claim/ send or check secure messages | /wps/portal/tdb/tricare4u/home/quick-links/7-submit-a-claim-send-or-check-secure-messages/!ut/p/z0/lY7LTsMwEEV_JSy6tGbSVG23FqgNpSkFUTV4g1zjJkMSO4kdXl9PAmIBCAlWozMzuueCgBSEkY-USU_WyLLnWzG928bxNA7nuF7yBSLfXV5vbvhViBcRrEB8eThbzpEnEzxPdlGE23BIoIemERyEssbrZw_pU-2CdzA-0CYryeUjHBZSeda5ER5tW32OIWHcJqdJBqKWPmdkjhbSj9t3_Y9-f9Y3HakiKMkUvXjGXHeoyDPJVCmpYk6be2ZbpnKtip5U12pWaedkpn9r-M-QuhCHl-h1rff85A1GCAda/ | /wps/portal/tdb/tricare4u/message-center/!ut/p/z0/jU7JDoIwFPwVPHgk7ymm4dpoEEUi0ZBgL6aSilUsS-v69YLGg3rxNJklMwMMEmCKn2XGjSwUzxu-YmQd-T7xey7OxiT2kJJg6cXzBWJAYArsIzAau0jDAU7C2HEw6rUNcl9VjAJLC2XE1UByKbX1JMpYQmW51LsutgJPjX3SXdwW9fENbUO_DodhBqzkZmdLtS0geXnf8z___p4_Cq15Juy0UUUN5YFtbs59Rmmn8wCW6P21/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | Submit a claim, send messages to customer service or check the status of a message already sent. | You must be logged in to your account to access secure messages. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to view the Message Center. |
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| Jul 21, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 8-share-access-to-my-account | Share access to my account | /wps/portal/tdb/tricare4u/home/quick-links/8-share-access-to-my-account/!ut/p/z0/jY7BbsIwEER_JT1wtHZDKpSrRQVpSyitihp8QcZyEjfBTmIHSr--BMSBIhCn1ezszhtgkADTfKMy7pTRvNzrBRssZ1E0iPwQJ2M6QqTzt4_pJ3338TWAF2BnB0_jEGn8iM_xPAhw5ncJ6ruuGQUmjHbyx0Gyrax3ENp5UmelsnkPuwUXjrS2h6lp1qfRJfSbeBhnwCrucqJ0aiA5ev_xF_3uxtetEoVXKl3swSGxOW8k4UJIa4kzZL3rhGm1u9Ln5ktVsNUu-J3IL_rwB6eTqO0!/ | /wps/portal/tdb/tricare4u/family-profile/family-profile/!ut/p/z0/jU5LC4JAGPwreugo36ppdhQDNRW8BLaX2MTVLd31sT3s15dFEHXpNMyDmQEMGWBOzqwkkglO6gffYnuXBoEd6A6KHeQ7yLUtKwq9pREFC1gD_gz4qymQzFGYbEwTpfrUwA5dh13AueCyuErILu2gPAmXSsHLmg3VDE0CyaV2GmaIir55w9Rg9ImXlIBbIiuNcSoge3lf87___p6npGH1qLW9oKwuoD3i_WjeYtdV1TuQl1UC/ | Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | Give a family member access to my account. | You must be logged in to share your account access. If you have an account, please login now. If you do not have an account please create an account. Once you complete the registration you will be able to view the Message Center. |
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| Jul 21, 2015 | uid=alfonso.ramos,o=defaultWIMFileBasedRealm/td> | 9-view-enrollment-information | View enrollment information | /wps/portal/tdb/tricare4u/home/quick-links/9-view-enrollment-information/!ut/p/z0/jZBPb4JAEMW_Cj1wJDNIY_S4sVHaSmuNRrqXZksW2LLs8mcV9dMLNB6s0fQ0eTNv5vcyQCEEqthOJMwIrZhs9Scdfi18f-i7I5zPyBSRrN-Xbyvy4eKrBy9ALwxPsxGS4BGfg7Xn4cLtLoifsqQEaKSV4XsDYVPUVi-UsbhKpKhTG7sGi4yzrW2MdZWfS3dhUAWTIAFaMJM6QsUawt_ZX_xVvn_jy62IMksKlbXgsbMTvHG4qrSUeevroVXev-VGoPs7RUa_D95xzjfk4QSF2n3Y/ | /wps/portal/tdb/tricare4u/benefits/enrollment/!ut/p/z0/jY5LC4JAFIX_ii5cyp18YUsxUEvBTWCziVFGndIZH9Pz16dFELVpdTn3HM53AEMGmJMzq4hkgpNm0jvs7NMwdMKFi2IXBS7yHNveRP7SSC0D1oA_A8FqDiQWipKtaaJ0MTewQ99jD3AhuKRXCdmlG5Wn4FKhvGrYWGtofpBC6qdRQ6UY2veZG4wh8ZMKcEdkrTNeCshe3hf-d9_f-JxyWjI5USkfRNO0kwvdEec38x57nqo-AOWBJOI!/ | Unauthenticated,Quick Links | /wps/wcm/connect/tdb/WPS+Content+English/Quick+Links | What do I need to do to enroll in TRICARE For Life? | . |
Unauthenticated,Quick Links |