How to appeal a TRICARE denial?

If TRICARE denies a claim or service, you have the right to appeal the decision through a formal process. The first step is to review the denial letter carefully to understand the specific reason for denial. Then, submit a written appeal to your regional contractor within 90 days of the initial denial notice. Your appeal should include a cover letter explaining why you believe the denial was incorrect, a copy of the denial letter, supporting medical records and documentation, a letter of medical necessity from your treating provider, and any additional clinical evidence supporting your case. The appeal process has multiple levels: the initial appeal is reviewed by the regional contractor, and if denied, you can request an independent external review. For appeals involving Medicare-eligible beneficiaries under TRICARE For Life, the process follows Medicare appeal procedures. Keep copies of all correspondence and track deadlines carefully. You may also contact the TRICARE Beneficiary Counseling and Assistance Coordinator (BCAC) at your nearest military treatment facility for free assistance with the appeals process.