Applications and claim forms are in PDF format readable with Acrobat Reader.

How to Apply

1. Complete both sides of our easy application form.
2. Sign and date the Application.
3. Make your check payable to USBA Group Health Program and mail it with your forms to:

Uniformed Services Benefit Association
P.O. Box 25956
Overland Park, KS 66225-0956

Questions? 1-800-368-7021

Premium Payment Methods

Your Tricare Standard/Extra Supplement Plan premiums can be deducted directly from your checking account every month. Just complete the attached form and return it to us with a voided check from the account you'll use for future payments.

If you prefer, we can bill you quarterly.

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NOTE: All Tricare supplement claims should be mailed to the address on the claim form, not to USBA.