Get the free DD Form 2876-2, "TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANA...
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CUI (when filled in)TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGER (PCM) CHANGE FORMOMB No. 07200008 OMB approval expires 20250930The public reporting burden for this collection
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How to fill out dd form 2876-2 quottricare
How to fill out dd form 2876-2 quottricare
01
Obtain a copy of the DD Form 2876-2 Quottricare from the TRICARE website or your healthcare provider.
02
Fill in your personal information, including name, address, and Social Security number.
03
Provide information about your healthcare coverage and any other relevant details requested on the form.
04
Review the completed form for accuracy and sign where indicated.
05
Submit the form to the appropriate healthcare provider or TRICARE office.
Who needs dd form 2876-2 quottricare?
01
Military service members and their dependents who are eligible for TRICARE benefits.
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What is dd form 2876-2 quottricare?
DD Form 2876-2 is a form used by beneficiaries to apply for TRICARE benefits, specifically for the TRICARE Young Adult program.
Who is required to file dd form 2876-2 quottricare?
Eligible dependents of service members, including those who have recently aged out of regular TRICARE coverage, are required to file DD Form 2876-2.
How to fill out dd form 2876-2 quottricare?
The form should be filled out by providing personal information, including the beneficiary's details, service member information, and coverage selection, then submitted to the appropriate TRICARE office.
What is the purpose of dd form 2876-2 quottricare?
The purpose of DD Form 2876-2 is to allow eligible dependents to enroll in the TRICARE Young Adult program and access necessary healthcare services.
What information must be reported on dd form 2876-2 quottricare?
Information such as the beneficiary's name, date of birth, Social Security number, contact information, and the sponsor's details must be reported on the form.
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