TRICARE Reserve Select & TRICARE Retired Reserve

To purchase TRICARE Reserve Select or TRICARE Retired Reserve coverage:

1. Log in to the Beneficiary Web Enrollment portal. 
2. Select “Purchase Coverage” and follow the instructions.
3. Print and sign the completed Reserve Component Health Coverage Request Form (DD Form 2896-1). This form is only available through the Beneficiary Web Enrollment portal.  

To log in to Beneficiary Web Enrollment, you must have one of the following:

• Common Access Card
• DFAS (MyPay) Account
• DS Logon

If you don’t qualify for TRICARE Reserve Select or TRICARE Retired Reserve, you won’t be able to complete or print the form. Contact your National Guard or Reserve personnel office for assistance.

If you have a technical problem, call 800-477-8227 for assistance. 

Mail or fax the completed application to your regional contractor at the address listed below.

	TRICARE Reserve Select	TRICARE Retired Reserve
East Region	Humana Military P.O. Box 105389 Atlanta, GA 30348-5389 Fax: 866-836-9535	Humana Military P.O. Box 105389 Atlanta, GA 30348-5389 Fax: 866-836-9535
West Region	TriWest Healthcare Alliance P.O. Box 8890 Virginia Beach, VA 23450-8550 Fax: 866-566-9915	TriWest Healthcare Alliance P.O. Box 8890 Virginia Beach, VA 23450-8550 Fax: 866-566-9915
Overseas Region	International SOS Assistance, Inc. TOP TRS Enrollments P.O. Box 11689 Philadelphia, PA 19116 Fax: +1-215-354-5015	International SOS Assistance, Inc. TOP TRR Enrollments P.O. Box 11689 Philadelphia, PA 19116 Fax: +1-215-354-5015