Other Health Insurance

Complete this form to notify your contractor that you have other health insurance (OHI). When you do, TRICARE is the second payer.

Download Form	Submit To:
East OHI Questionnaire	TRICARE East Region P.O. Box 7981 Madison, WI 53707-7981 Fax: 608-221-7536
West OHI Questionnaire	Health Net, LLC P.O. Box 202102 Florence, SC 29502-2102
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

Last Updated 1/25/2022