How
to Enroll in the TRICARE Supplement Plans
It
is Easy to Enroll
1.
Download the appropriate Enrollment Form (from our
Download Page) for the TRICARE Plan you are applying
for
2. Print your name and address clearly on the
Enrollment Form.
3. Sign and date the applicable Enrollment Form as
indicated.
4. Check the appropriate boxes to indicate the coverage
you have chosen
5. Calculate your premium from the appropriate schedule
shown (Complete the Checkomatic Form on reverse side of
enrollment form if you wish to pay premiums monthly).
6. Make your check payable to “ RAUS Group Health
Program” and mail it with your enrollment form to:
RAUS Insurance
Administrator
P.O Box 2107
Rockville, MD 20847
Effective
Date of TRICARE Supplement Coverage
Your coverage will become effective on the first day of
the month following receipt of your completed and
signed enrollment form and first premium payment. If
you are confined in a hospital on the date you are to
become covered under the policy, your coverage will be
deferred until the first day after you are discharged.