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Reserve Component Purchased TRICARE Application

Through the Reserve Component Purchased TRICARE Application, you can purchase:

  • TRICARE Reserve Select
  • TRICARE Retired Reserve

Qualify and Purchase

  1. Log on to the DMDC Reserve Component Purchased TRICARE Application*
  2. Select "Purchase Coverage" and follow the instructions.
  3. Print and sign the completed Reserve Component Health Coverage Request Form (DD Form 2896-1).
  4. Mail or fax the completed form to your regional contractor.

If you don't qualify, you won't be able to complete or print the form. You can also view member information, add or delete family members or disenroll through this website.

Last Updated 8/10/2016

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Reserve Component Purchased TRICARE Application (RCPTA)

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