Other Health Insurance

Complete this form to notify your contractor that you have other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance.". When you do, TRICARE is the second payer.

Download Form	Submit To
East Region OHI Questionnaire	TRICARE East Region P.O. Box 7981 Madison, WI 53707-7981 Fax: 608-221-7536
West Region OHI Questionnaire	TRICARE West Region ATTN: TriWest P.O. Box 202168 Florence, SC 29502 Fax: 877-989-0060
Overseas OHI Questionnaire	TRICARE Overseas P.O. Box 7992 Madison, WI 53707-7992 (USA)
TRICARE For Life OHI Questionnaire	WPS/TRICARE For Life P.O. Box 7889 Madison, WI 53707-7889 Fax: 608-301-2114

Looking for Health Net Federal Services’ OHI form? Visit the Health Net Federal Services website for more.