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How do I file a TRICARE claim?
Verified by TRICARE.com Editorial Team
Updated 2024-12-01
AI-assisted (gemini)
Quick Answer
Network providers file claims for you. For non-network providers or overseas care, submit DD Form 2642 with itemized bills to your regional contractor.
Key Takeaways
- Network providers file for you
- Non-network requires you to file
- Use DD Form 2642
- Submit within 1 year
Detailed Answer
Most claims are filed automatically, but some require beneficiary action.
When Claims Are Filed For You
- Network provider visits
- MTF care
- Most in-network pharmacy
- Hospital stays (network)
When You Must File
- Non-network provider visits
- Overseas non-contracted care
- Paying out of pocket
- Emergency care abroad
How to File a Claim
- Complete DD Form 2642
- Attach itemized bill
- Include medical records if available
- Submit to regional contractor
Filing Deadlines
- Within 1 year of service
- Overseas: 3 years in some cases
- Late claims may be denied
What to Include
- Patient information
- Provider information
- Diagnosis codes
- Procedure codes
- Itemized charges
- Proof of payment
Tracking Claims
- Use online portal
- Check Explanation of Benefits (EOB)
- Call contractor for status
Related TRICARE Terms
Related Questions
What is an Explanation of Benefits (EOB)?
An EOB is a statement from TRICARE showing services billed, amounts TRICARE paid, and any amount you owe. It is not a bill.
How do I appeal a TRICARE decision?
Appeal denied claims or coverage decisions within 90 days by submitting a written appeal with supporting documentation to your regional contractor.