Defense Health Agency-Great Lakes
For remotely located Active Duty and Reserve Component service members, the Defense Health Agency (DHA) - Great Lakes (fomerly known as MMSO) (DHA-GL):
- Gives pre-authorization for civilian medical care
- Authorizes payment of civilian medical claims
- Coordinates civilian health care services for remotely located service members
- Collaborates with unit representatives regarding line-of duty (LOD) care for remotely located service members
The forms below are submitted to the DHA-GL. Instructions and addresses are found on each form.
- Medical Eligibility Request—To verify your eligibility for medical care.
- Pre-Authorization Request for Medical Care—To get authorization for medical care
- Pre-Authorization Request for Surgical Care—To request authorization for surgical care.
- Formal Appeal Request—To submit a denied medical claim or pre-authorization request.
- DHA-GL 07 DVA/DoD MOA Initial Referral & Authorization for SCI-TBI-Blind Rehab
- DHA-GL 07a DVA/DoD MOA Continued Stay for SCI-TBI-Blind Rehab
- DHA-GL 08 DVA-DoD SCI-TBI-Blind DME Request Worksheet
- DHA-GL 41 Worksheet DOD/VA MOA Inpatient-Outpatient Continued Stay Review
Review the instructions below for DHA-GL processes and procedures.
- DHA-GL Process Guide
- How to forward medical eligibility documentation to DHA-GL
- How to submit pharmacy reimbursement for Guard and Reservist with line of duty (LOD) injuries/illness
- How to submit a request for pre-authorization for line of duty (LOD) care
- How to submit a formal appeal
- How to get a medical bill removed from a credit report
- How to submit Initial pre-authorization DVA DoD MOA
- How to submit Continuity of Care pre-authorization DVA DoD MOA
- Information on the Fair Debt Collection Practices Act
Last Updated 11/29/2019