Get Dd 2876 2016-2025

The DD 2876 form is essential for enrolling, disenrolling, or changing your primary care manager in TRICARE Prime and other related programs. This guide aims to provide clear and comprehensive instructions to assist you in completing the form online, ensuring a smooth and efficient process.

Follow the steps to fill out the DD 2876 properly.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering the sponsor's information in Section I. This includes providing the social security number (SSN) or DoD benefits number, name, telephone number, email address, date of birth, residence address, mailing address, and military assignment details.
3. Select the TRICARE Prime option you desire, noting that active duty service members must enroll in TRICARE Prime. Indicate your requested action, such as enroll, transfer enrollment, PCM change, or disenroll.
4. In Section II, complete the information for any enrolling family members or those undergoing a PCM change. This includes their names, dates of birth, residence addresses, and any requested actions.
5. If applicable, use Section III to clarify the reason for disenrollment or PCM change, specifying factors such as relocation or dissatisfaction.
6. In Section IV, disclose any other health insurance coverage for family members. Provide details such as policy holder names and insurance carriers.
7. Complete Section V by waiving the drive time if necessary, affirming your understanding of TRICARE policies, and signing the form. Include the date signed.
8. If you are a retiree or eligible former spouse, navigate to Section VI to choose your payment options for TRICARE Prime enrollment fees.
9. Finally, review all entered information for accuracy, save your changes, and proceed to download, print, or share the form as needed.

Start filling out your DD 2876 online today for a seamless enrollment experience.