TRICARE Prime Options

To disenroll from TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas:

1. Log into the Beneficiary Web Enrollment website or download your region’s disenrollment form:
   • East Enrollment Form
   • West Enrollment Form
   • Overseas Enrollment Form
2. Complete the Sections I and III of the form. In Section I:
   • Check the box for “Disenroll”
   • Add the effective date in #9
   • Skip #10
3. Mail the form to your regional contactor at the address listed below:

East	Humana Military P.O. Box 105838 Atlanta, GA 30348-5838
West	Health Net, LLC P.O. Box 8458 Virginia Beach, VA 23450-8548
Overseas	International SOS Assistance TOP Prime Enrollments P.O. Box 11520 Philadelphia, PA 19116

If enrolled in the US Family Health Plan, please visit US Family Health Plan | TRICARE.

Note: Active duty service members are not allowed to disenroll. All others can choose to disenroll at anytime, but may be subject to a one-year lock out from re-enrolling.