How does TRICARE provider reimbursement and claims filing work?

Direct answer: In most cases your provider files the claim for you; you generally only file your own claim when seeing a non-network or non-participating provider, getting care overseas, or getting care outside your region.

Applies to: All TRICARE plans · All regions

Details

TRICARE claims processors process most claims within 30 days. To file a claim yourself, gather itemized bills and receipts and complete a Patient’s Request for Medical Payment (DD Form 2642), filling out all 12 blocks and signing it. Reimbursement is paid at the TRICARE-allowable amount, which does not include your copayments, cost-shares, or deductibles — those remain your responsibility.

What to do next

Confirm this with your Primary Care Manager or regional contractor before scheduling — rules can vary by region and by service.