What is DD Form 2876-1? It is a Department of Defense form titled DD 2876-1, TRICARE Prime Enrollment, Disenrollment, and PCM Change Form, and its job is straightforward: TRICARE Prime Enrollment, Disenrollment and Primary Care Manager (PCM) Change Form (EAST). That single line covers most of what people want to know before they download it.
Does it apply to your branch? Yes. The DD prefix means Department of Defense, not one service, so the same blank serves the Army, Navy, Air Force, Marine Corps, Space Force and the Coast Guard under Defense jurisdiction. There is no Army version and no Navy version to search for.
Where does the requirement come from? From not stated, with not stated responsible for the document itself. Those are the names to cite if anyone asks under what authority you filed.
Which edition should you have? not stated, listed as not stated. A copy dated otherwise is a copy worth replacing.
What the form asks for
- Contractor's website.
- TRICARE Prime option desired. Press space bar to mark X in first box if TRICARE Prime, second box if TRICARE Prime Remote, third box if TRICARE Overseas Program Prime, or fourth box if Uniformed Services Family Health Plan.
- Section I - Sponsor information. 1. Sponsor name (last, first, middle initial) (must match DEERS).
- Sponsor's social security number or DoD Benefits Number (DBN).
- 3. Sponsor is: X first box if active duty, second box if retired, third box if deceased, or fourth box if unremarried former spouse.
- 4. Sponsor's work telephone number (include area code/extensions).
- 5. Sponsor's email address.
- 7. Sponsor's residence address (street, apartment number, city, state, zip code, country).
- X if new address.
- 8. Sponsor's mailing address (provide APO or FPO if stationed overseas).
- X if same as residence address.
- X if new address.
- 9. Sponsor's military assignment. a. Unit.
- b. Unit identification code (if known).
- c. State, zip code and country of work address.
- 10. Requested action. X first box if none for sponsor (go to section II - family), second if enroll, third if transfer enrollment, fourth if PCM change, or fifth if disenroll.
- 11. Sponsor primary care preference. a. PCM, first choice. X first box if military treatment facility, second box if PRP (active duty only), third box if civilian.
- Primary care manager full name or MTF/clinic.
- b. Second choice. X first box if military treatment facility, second box if civilian.
- Primary care manager full name or MTF/clinic.
- c. PCM specialty. X first box if no preference, second box if family/general practice, third if internal medicine, or fourth if flight medicine.
- d. Preferred PCM gender. X first box if no preference, second box if male, third box if female.
- Section II - Enrolling family members. 12.a. First family member name (last, first, middle initial) (must match DEERS).
- b. Date of birth (4 digit year, 2 digit month, 2 digit day).
Download the form
What formats exist for this form? PDF. What is the scale of it? 5 pages and approximately 152 fields.
Is there a charge? No — free, all formats. Where should you open the file? In a full pdf application on your own machine. Browser-embedded viewers handle field properties unpredictably.
In what order do you complete it? The printed order, top to bottom. Header data comes before the body, and the body before the signature block. The sequence is not decorative — later entries are keyed to earlier ones.
What if your copy is old? Replace it. Check the date printed on the form against not stated. Old blanks circulate for years in shared folders, and because a DD revision lands across the whole Department at once, the receiving office will be working from the new layout.
Is the form its own instruction manual? Partly. The rest sits in not stated, which is also the authority where the two texts conflict.
Who receives it? The office not stated designates, subject to whatever local instruction your organization adds. What do you keep? A copy, made before the form leaves your hands.
How do you find a form referenced inside this one? By its number alone. The DD sequence runs across the entire Department, so a number identifies exactly one document regardless of which service cited it.
Can you assume a matching number is the same form? No, and this is where downloads go wrong. Read the prefix. Army numbering and Department numbering are independent systems, so the digits alone tell you nothing about which document you need.
Should you archive this file and reuse it next year? Better not. Forms are revised as directives are reissued, as data requirements shift and as statutory notice text is updated, and none of that reaches you directly. Download fresh, check the edition date.
Is any of this advice? No. This page distributes a published Defense form and explains its contents, which is a different thing from telling you whether your circumstances qualify or whether a reviewer will accept your copy. Direct questions of eligibility, applicability and procedure to not stated, to your servicing personnel office, or to the office designated in not stated.
Questions and answers
- What is DD Form 2876-1?
- DD 2876-1, TRICARE Prime Enrollment, Disenrollment, and PCM Change Form
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?