TRICARE Young Adult Application
Use the TRICARE Young Adult Application (DD Form 2947) to purchase TRICARE Young Adult. Select the form for the region where you live.
Mail or fax the completed application and your initial premium payment (equal to two months) to your regional contractor at address/fax number listed below.
Note: If you have selected a US Family Health Plan provider with the Prime Option, those addresses are found on the form.
Health Net Federal Services, LLC
P. O. Box 105402
Atlanta, GA 30348-5402
Humana Military Healthcare Services
TRICARE Young Adult Program
P. O. Box 538025
Atlanta, GA 30353-8025
UnitedHealthcare Military & Veterans
TRICARE West Region Enrollment Department
P.O. Box 105492
Atlanta, GA 30348-5492
International SOS Assistance, Inc.
P. O. Box 11520
Philadelphia, PA 19116