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  • Dd Form 2876

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TRICARE PRIME ENROLLMENT APPLICATION AND PCM CHANGE FORM (Please read Agency Disclosure Notice, Privacy Act Statement, and Instructions before completing this form.) AGENCY DISCLOSURE NOTICE Form.

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Your child is automatically enrolled in TRICARE Select when registered in DEERS.

TRICARE Reserve Select (TRS) provides qualified National Guard and Reserve members a premium-based healthcare plan, similar to TRICARE Select through payment of a monthly premium.

With TRICARE Prime, your provider will file claims for you in most cases. Under TRICARE Select, you aren't required to have a PCM. You manage your own health care and can receive care from any provider. However, you can save money with TRICARE Select if you see a TRICARE-authorized network provider.

If you're on active duty, you have to enroll in TRICARE Prime. All others can choose to enroll in TRICARE Prime or TRICARE Select.

Use the TRICARE Prime Enrollment, Disenrollment and Primary Care Manager (PCM) Change Form (DD Form 2876) to enroll in one of the TRICARE Prime Options: TRICARE Prime.

With TRICARE Prime, your provider will file claims for you in most cases. Under TRICARE Select, you aren't required to have a PCM. You manage your own health care and can receive care from any provider. However, you can save money with TRICARE Select if you see a TRICARE-authorized network provider.

TRICARE Prime Step 1: Choose a Primary Care Manager (PCM) You may select a military or network provider as your PCM. ... Step 2: Complete the Enrollment Application. Enroll all family members on one enrollment form. ... Step 3: Get Started with TRICARE Prime.

If you don't have internet access, you can get a letter in the mail. Contact the DMDC Support Office at 1-800-538-9552.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232