DA Form 5027-R. Medcase Program Requirement (LRA)

Form DA 5027-R is a Medcase Program Requirement (LRA). This form is used in the Army to request medical case management services for eligible beneficiaries. The purpose of this form is to initiate the process of providing comprehensive medical case management to individuals with complex medical needs.

The form consists of sections where the requesting party provides information about the beneficiary's medical condition, their eligibility for medical case management services, and the specific services required. The form may also include sections for documenting the contact information of the requesting party and any additional details related to the medical case.

Important fields in this form include accurate and detailed information about the beneficiary's medical needs and the specific services required. Properly identifying eligible beneficiaries and their medical requirements is essential to ensure they receive the appropriate care and support.

Application Example: A military family member with a complex medical condition requires specialized medical case management services. The family or a healthcare provider uses Form DA 5027-R to request these services, outlining the beneficiary's medical needs and the type of case management required.

Related Forms: There may be other forms used for requesting various medical services and support for eligible beneficiaries.