RayW.MachadoJRMedical

UnitedHealthcare Military & Veterans
TRICARE West Enrollment Dept.
P.O. Box 105492
Atlanta, GA 30348

 40 K

Dear TRICARE Prime Beneficiary:

Welcome to TRICARE Prime, the health care plan for active duty and retired service members,
their families, and other eligible beneficiaries. The advantage of TRICARE Prime is having a primary
care manager (PCM) who acts as your principal health care provider, offering ongoing care while
referring you for tests and specialty care when necessary. If you have a military hospital or clinic
PCM, you can use the TRICARE Online Web site at www.tricareonline.com to make appointments.
If you have a civilian PCM, you are encouraged to make initial contact with your new PCM within 30
days to establish yourself as a new patient. TRICARE encourages an open and active relationship
between you and your health care provider so you can work together to meet your health care needs.

The Affordable Care Act, also known as the health care reform law, requires that individuals
maintain health insurance or other health coverage that meets the definition of "minimum essential
coverage" beginning in 2014. Please note that the TRICARE program meets the minimum essential
coverage requirement. For more information about the Affordable Care Act, visit
www.tricare.mil/aca.

Your Enrollment Cards
qYour PCM's name and phone number are listed below. If this information is not listed, you may call
the TRICARE phone number found on the back of the card for more information.

qRemove your TRICARE Prime enrollment card from this letter and write your PCM's name and
phone number in the space provided. TRICARE civilian network providers may require you to show
the enrollment card and your valid uniformed services identification card at the time of service.

For more information about your TRICARE Prime benefit, please visit the UnitedHealthcare Military
& Veterans Web site at www.uhcmilitarywest.com or call 1-877-988-WEST (1-877-988-9378). You
can also visit the TRICARE Web site at www.tricare.mil. You will receive e-mail messages from the
Defense Manpower Data Center directing you to milConnect to get correspondence related to your
TRICARE benefit. You should provide your e-mail address in milConnect to make sure you receive
important information about your TRICARE benefit. Visit http://milconnect.dmdc.mil to sign up.

TRICARE's goal is the same wherever you are to provide access to the best possible health care for
those entrusted to our care. We look forward to serving your health care needs.

Your Primary Care Manager Information:
LAIRD,RODERICK
PCM phone not available

Sincerely,
Enrollment Department
UnitedHealthcare Military & Veterans

  TRICARE Information: 1-877-988-WEST (1-877-988-9378)
ETnRrIoClAlmReEnPt rCima red TRICARE Pharmacy Program: 1-877-363-1303
Medical Claims: Contact your regional contractor or visit:
  www.tricare.mil/claims (stateside);
www.tricare-overseas.com (overseas)
Name: Ray W. Machado JR Emergency Care: Call 911 or go to the nearest medical facility.
Status: Active Duty Sponsor Contact your PCM as soon as possible to coordinate further
Primary Care Manager: care and payment before leaving the facility.
Primary Care Manager Phone:
Effective Date: 31 Dec 2014 www.tricare.mil

Valid with presentation of uniformed services ID card.
Contact your personnel office to correct the above information.