Claims Filing Deadline

The claims filing deadline is the maximum time allowed to submit a claim to TRICARE for payment or reimbursement of covered healthcare services. Missing the filing deadline may result in denial of the claim and full financial responsibility for the beneficiary.

TRICARE claims filing deadlines: • Standard deadline: One year from the date of service • Retroactive eligibility: One year from the date eligibility is established in DEERS • Overseas claims: One year from the date of service • Medicare crossover claims: May have different timelines

Who files claims: • Network providers: Required to file claims on your behalf (no action needed from you) • Non-network providers: May or may not file for you • Overseas providers: You typically file claims yourself • Pharmacy claims: Usually filed automatically by the pharmacy

Steps to file a claim: • Complete DD Form 2642 (Patient's Request for Medical Payment) • Attach itemized bills and proof of payment • Include provider information and diagnosis codes • Submit to your regional contractor (Humana Military or TriWest)

Tips for timely filing: • Keep copies of all medical bills and receipts • Track dates of service and submission dates • Set reminders well before the one-year deadline • File as soon as possible after receiving care

If a claim is denied for late filing, you may submit an appeal with documentation showing why the delay occurred.