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	TriWest Healthcare Alliance P.O. Box 8550 Virginia Beach, VA 23450
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.