Other Health Insurance
Complete this form to notify your contractor that you have . When you do, TRICARE is the second payer.
| Download Form | Submit To |
|---|---|
|
PGBA—Other Health Insurance P.O. Box 202151 Florence, SC 29502 Fax: 877-489-0038 |
|
| West Region OHI Questionnaire |
TRICARE West Region ATTN: TriWest P.O. Box 202168 Florence, SC 29502 Fax: 877-989-0060 |
|
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 Fax: 608-301-2114 |
Last Updated 8/21/2025