USFHP Forms, Provider Directory & Resources

TRICARE Costs

• 2025 TRICARE Costs

Member Resources

• 2025 USFHP Member Handbook (PDF)
• USFHP Grievance, Reconsideration, and Appeal Request Form (PDF)
• Member Advisory Committee (MAC) Meeting Information
• US Family Health Plan beneficiaries have access to a toll-free 24-hour nurse line. Call the number 800-455-9355 to speak with a registered nurse at any time, day or night. If you are experiencing a medical emergency, please dial 911.

Claims & Reimbursement Forms 

• USFHP Medical Reimbursement Form
• USFHP OOA and RX Reimbursement Form
• Travel Reimbursement Voucher

Enrollment Applications

• USFHP TRICARE Prime East Enroll/Disenroll PCM Change Form (PDF)
• USFHP TRICARE TYA Enrollment Application (PDF)

Legal Documents

• Authorization to Disclose Personal Information (PDF)
• TX Out-of-hospital DNR (PDF)
• TX Statutory Advance Medical Directive (PDF)
• TX Statutory Durable Power of Attorney (PDF)
• US Family Health Plan Privacy Notice (PDF)

Pharmacy Resources

• USFHP MaxorPlus DoD Mail Order Form (PDF)
• Maxor Pharmacy Benefits Booklet 

Provider & Pharmacy Directory

• 2025 USFHP Provider & Pharmacy Directory - Texas (PDF)
• 2025 USFHP Provider & Pharmacy Directory - Louisiana (PDF)

Provider Search Tools

• Online Searchable Provider Directory

TRICARE® is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved. Last Updated 04/15/2025