You must request and complete a Health Benefits Cancellation/Suspension
Confirmation form, RI 79-9. If you are a TRICARE/TRICARE For Life enrollee,
you must provide a copy of your Uniformed Services Identification (ID)
card and, if over age 65, a copy of your Medicare card showing Parts
A and B along with the completed Health Benefits Cancellation/Suspension
Confirmation form. If you are a CHAMPVA enrollee, you must provide a
copy of your CHAMPVA Authorization card (A-card) along with the completed
Health Benefits Cancellation/Suspension form. To suspend your FEHB Coverage for the Peace
Corps, you must provide us with evidence of your eligibility.
If you are on the rolls of the Office of Workers Compensation (OWCP), you
must contact your OWCP office in order to request this suspension.
If you pay your FEHB premiums by direct payment, you must contact the National
Finance Center concerning the suspension of your enrollment. The toll-free
number is 1-800-242-9630
For further information concerning TRICARE/TRICARE For Life, call toll-free
1-888-363-5433 or access the Web site at
www.tricare.osd.mil.
For further information concerning CHAMPVA, call 1-800-733-8387 or access
the Web site at
www.va.gov/hac.