Get the free DD Form 2876, "TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGE...

Name: Fillable Online DD Form 2876, "TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGER (PCM) CHANGE FORM" Fax Email Print - pdfFiller
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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 quottricare

01

Obtain a blank copy of DD Form 2876 Quottricare.

02

Fill out the personal information section, including name, rank/grade, social security number, and contact information.

03

Provide information about your primary care manager (PCM) and any dependents covered under Tricare.

04

Fill in the requested information regarding your medical and dental coverage.

05

Sign and date the form where indicated.

06

Submit the completed form to the appropriate Tricare office or provider.

Who needs dd form 2876 quottricare?

01

Any military service member or eligible dependent who is enrolled in Tricare and wishes to document their medical and dental coverage needs to fill out DD Form 2876 Quottricare.

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What is dd form 2876 "tricare"?

DD Form 2876 is a form used to apply for and enroll in the TRICARE health care program for active duty and retired military members and their eligible family members.

Who is required to file dd form 2876 "tricare"?

Active duty service members, retired service members, and their eligible family members are required to file DD Form 2876 for TRICARE enrollment.

How to fill out dd form 2876 "tricare"?

To fill out DD Form 2876, individuals must provide personal information such as name, social security number, address, and details about their military service, as well as the information of family members being enrolled.

What is the purpose of dd form 2876 "tricare"?

The purpose of DD Form 2876 is to apply for TRICARE benefits and to enroll eligible individuals in the TRICARE health care program.

What information must be reported on dd form 2876 "tricare"?

The form requires details such as personal identification information, military status, dependent information, and health care plan preferences.

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