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Make Sure You're Eligible

As mandated by the DoD, each of the six US Family Health Plans serves its own area of the country, defined by zip codes. To see if you live in an eligible zip code where we can provide you service as a member of the Johns Hopkins US Family Health Plan, use the zip code search tool

Enrollment Options

You can enroll in Johns Hopkins US Family Health Plan by either calling our enrollment department, downloading the application and submitting via mail or fax. Enrollment is open year-round. 

By Phone

Call 410-424-4780 between 8:30 am and 4:30 pm Monday through Friday.

Please have the following information ready:

  • The Sponsor’s social security number
  • Primary care provider from our Find a Doctor page for each person enrolling
  • Payment method for enrollment fee, if military retired

By Mail or Fax

Complete the steps below and download the application as well as other forms that you may need. The files are in Adobe Acrobat PDF format. If you are not sure how to download these documents to your computer, please view these Instructions

Some helpful tips to complete the Mail or Fax process:

Watch a Step-by-Step Video

We'll guide you on how to fill out the Enrollment Application

Enrollment Application Form
Remember you can type information into this form before you print it.
Note: Enrollment Fee changes October 1, 2015

TRICARE Young Adult Application Form
Fill out this form if you are also applying for TYA coverage. Current rate: $319/per month (effective Jan 1, 2017).

Automatic Payment Form 
You only need to use this form if you choose monthly premium payment from a savings, checking or credit card account.

Mail or fax your completed forms to:

Johns Hopkins US Family Health Plan
Enrollment Department 
P.O. Box 815
Glen Burnie, MD 21060-0815
Fax: 410-424-4770

Please note: If you want to confirm application receipt or status of your application, please call Customer Service at 800-808-7347.

By BWE (online at TRICARE Beneficiary Web Enrollment)

Go to the Beneficiary Web Enrollment site.

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Enrollment Period

Enrollment in the US Family Health Plan is for a 12-month period. At the end of the enrollment period, members are automatically re-enrolled for another 12-month period.

Enrollment Fee (as of October 1, 2015)

Active-duty family members - $0 
Individual rates - $282.60 (yearly) /  $70.65 (quarterly) /  $23.55 (monthly) 
Family rates - $565.20 (yearly) $141.30 (quarterly) /  $47.10 (monthly)

You may pay your enrollment fee, if applicable, in one annual payment or quarterly payments. Members will receive notice of when annual or quarterly payment is due. Visa, MasterCard and Discover are all accepted. There is also a convenient automatic payment plan that debits a checking account or credit card account. 

US Family Health Plan members may also use monthly allotments (deductions made by the Department of Defense) from military retirement pay. The deducted amount will be applied automatically to your Plan enrollment fee each month. Monthly deductions will be $23.55 for an individual or $47.10 for a family.

Disenrollment

If you are involuntarily disenrolled because of non-payment, you must wait 12 months before you may re-enroll in the US Family Health Plan.