Claim

Request for payment of covered medical services.

A claim is a formal request for TRICARE to pay for healthcare services you received. In most cases, your provider submits claims directly to TRICARE on your behalf. However, when using non-network providers, you may need to file claims yourself.

Types of claims: • Electronic Claims: Filed by providers through secure systems (fastest processing) • Paper Claims: Manual submission using DD Form 2642 (slower processing)

Who files claims: • Network providers: Always file claims for you • Non-network providers: May file for you or require you to file • Overseas providers: You typically file claims yourself

Claim processing timeline: • Network providers: Usually 30 days • Non-network providers: 30-45 days • Overseas claims: 60-90 days

Filing deadline: Claims must be submitted within one year of the date of service (or one year from the end of the fiscal year for active duty family members).

Track your claims online through the TRICARE beneficiary portal or by contacting your regional contractor.