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Remember to bring your yellow card and present it when using all clinic services, including pharmacy pickup. For the convenience of our beneficiaries, the latest version of the Lyster Yellow card is now a “Family Friendly” card which lists all family members on the back of the card who have a completed DD2569 form. Consult with your clinic staff, pharmacy staff, or contact Lyster’s Third Party Collection in the Resource Management division to receive your yellow card. Filing a DD2569 form is an annual regulatory requirement that every beneficiary (except the active component) must complete.

You do not have to complete a DD2569 at each visit. If you do not bring your current yellow card, you will be asked to complete another DD2569 form, so please bring your card to all clinic visits, including pharmacy pickup.

If you have any questions, please call Third Party Collection at (334) 255-7139/7689/7241. The team is happy to help you.

More information on the Third Party Collection Program.
Title 10, United States Code (USC), Section 1095 authorizes Military Treatment Facilities (MTFs) to recover from third party payers the cost of providing health care services to DoD covered beneficiaries. The Third Party Collection Program (TPCP) is the military program established to accomplish this task.

All beneficiaries, except active duty, are required to provide information regarding Other Health Insurance (AHO) coverage annually or when their coverage status changes. MTF’s business offices will bill OHI or third party payors directly for reasonable costs for care, less any deductible or co-payment amount applicable to the beneficiary. DoD recipients are not responsible for deductibles or copayments. The rates used for billing are included in the Standard Adjusted Inpatient Amounts (ASA) and Outpatient Packages approved annually by the Assistant Secretary of Defense for Health Affairs. Funds raised through the TPCP are used to improve health care delivery at the MTF providing the care.

Frequently Asked Questions
Read the following questions and answers to learn more about collecting and verifying other health insurance information.

What is Other Health Insurance (AHO)?

Other health insurance (OHI) is any health insurance policy covering medical, dental or pharmaceutical care that you may have through your employer or private insurance company. TRICARE, TRICARE Supplemental Plans, Medicare, Medicaid, and some government-sponsored programs are not OHI. If you have OHI and are covered by TRICARE, federal law requires Military Treatment Facilities (MTFs) to collect reasonable payments from third-party payers (unless you are on active duty). The money collected (commonly referred to as a “reimbursement” or “rebate”) supports the operations and maintenance budget of the MTF where you receive your care. OHI reimbursements help your MTF improve the quality of healthcare.

What is the DD 2569 form and why should I complete it?

DD Form 2569 is how you notify the DoD of your IHO. The information provided on the DD 2569 form is used to properly route a healthcare claim to your OHI provider.

Who should complete this form?

All DoD recipients, except active duty, must complete DD Form 2569. This includes active duty family members, retirees, and family members of retirees.

How often should I complete the DD 2569 form?

At each visit, you must notify the DoD of any OHIs you have or any changes since your last appointment. A DD 2569 form must be completed annually and when your insurance coverage or information changes. Health plan information (see below) may change between appointments and from year to year. Please verify that you have the most up-to-date health insurance information with your insurer and report it on DD Form 2569. Some MTFs use DD Form 2569 compliance cards which allow beneficiaries to certify that the form has been completed . Recipients should always update DD Form 2569 with any changes and renew their IHO registration card, usually on the anniversary of the issue date shown on the card or when IHO status or information is updated .

What are my responsibilities?

AT 5 :
Provide information about your IHO coverage. This information includes:

Policy name and number
Type of coverage
Patient-insured relationship
Policy Effective Dates
OHI will not limit your access to care. But if you intentionally fail to provide information about your OHI, you could be disqualified for MTF healthcare services.

Will I receive an invoice if OHI does not pay or only pays part of the MTF invoice?

No. You will not be charged for care at an MTF (with the exception of hospital care-related living expenses or co-payment for TRICARE services provided downtown). In all cases where third-party payment is received, it will be deemed to satisfy normal medical services or living expenses, and you will not be required to make any further payment.