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DD Form 3043 TRICARE Select Enrollment, Disenrollment, and Change Form
What Is DD Form 3043?
This is a form that was released by the U.S. Department of Defense (DoD) on October 1, 2018. The form, often mistakenly referred to as the DA Form 3043 , is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.
FAQ
Q: What is the DD Form 3043?
A: The DD Form 3043 is the TRICARE Select Enrollment, Disenrollment, and Change Form.
Q: What is TRICARE Select?
A: TRICARE Select is a health insurance program for active duty, retired, and National Guard/Reserve members and their families.
Q: What is the purpose of DD Form 3043?
A: The purpose of DD Form 3043 is to enroll, disenroll, or make changes to TRICARE Select coverage.
Q: When should I use DD Form 3043?
A: You should use DD Form 3043 when you want to enroll, disenroll, or make changes to your TRICARE Select coverage.
Q: What information is required on DD Form 3043?
A: DD Form 3043 requires information such as your personal details, sponsor information, and desired changes to your TRICARE Select coverage.
Q: Are there any fees associated with TRICARE Select?
A: Yes, there are annual enrollment fees for most TRICARE Select beneficiaries.
Q: Can I make changes to my TRICARE Select coverage anytime?
A: No, there are specific enrollment or change periods during the year for TRICARE Select.
Form Details:
- A 4-page document available for download in PDF;
- The latest version available from the Executive Services Directorate;
- Editable, printable, and free to use;
- Fill out the form in our online filing application.
Download an up-to-date fillable DD Form 3043 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.
Download DD Form 3043 TRICARE Select Enrollment, Disenrollment, and Change Form
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