TRICARE Plus
TRICARE Plus Disenrollment Request form (DD Form 2854)
- Use this form to disenroll from TRICARE Plus.
- Submit a copy to the military hospital or clinic where you’re enrolled.
Last Updated 8/21/2025
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Patient Resources
Resources for patients.TRICARE Plus Disenrollment Request form (DD Form 2854)
Last Updated 8/21/2025