US Family Health Plan

TRICARE Costs

• 2024 TRICARE Costs

Member Resources

• 2025 USFHP Member Handbook (PDF)
• 2025 USFHP Beneficiary Handbook (PDF)
• USFHP Grievance, Reconsideration, and Appeal Request Form (PDF)
• Member Advisory Committee (MAC) Meeting Information

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

• Notice of USFHP 2024 Pharmacy Copay Increase
• USFHP MaxorPlus DoD Mail Order Form (PDF)
• Maxor Pharmacy Benefits Booklet 

Provider & Pharmacy Directory

• 2024/2025 USFHP Provider & Pharmacy Directory - Texas (PDF)
• 2024/2025 USFHP Provider & Pharmacy Directory - Louisiana (PDF)

Provider Search Tools

• Online Searchable Provider Directory

If you don’t see what you’re looking for, contact us or call 1-844-282-3100. We can help you find the plans, forms and resources you need.