Filing Health Care Claims Under the Demonstration
One of the main benefits of the TRICARE Philippine Demonstration is that Approved Providers will file claims for you and you'll receive an explanation of benefits (EOB). Give your provider your physical home mailing address so he/she can file the claims. P.O. boxes and Retired Activities Office boxes cannot be used.
- The Approved Demonstration Provider may request up front payment. If so, your deductible and cost share is the only amount you're required to pay. The provider will file a claim with TRICARE for the remaining amount.
- If payment was not made up front, the provider will follow up with you after receiving your TRICARE explanation of benefits to collect payment of your cost share and deductible.
If You Have to File a Claim
The only time you should have to file your own claims under the demonstration is if you requested and received a waiver from International SOS to get care from a non-Approved Demonstration Provider. In this scenario, follow the steps below to file a claim:
1. Download and fill out a TRICARE claim form, the Patient's Request for Medical Payment (DD Form 2642).
2. Attach a readable copy of the provider's bill to the claim form, making sure it contains the following:
- Sponsor's Social Security number (SSN) (eligible former spouses should use their SSN)
- Provider's name and address (if more than one provider's name is on the bill, circle the name of the person who treated you)
- Date and place of each service
- Description of each service or supply furnished
- Charge for each service
- Diagnosis (if the diagnosis is not on the bill, be sure to complete block 8a on the form)
3. Fill out all 12 blocks of the form correctly and sign it.
4. Make a copy of the paperwork for your records.
5. Mail your completed claim form to:
TRICARE Overseas Program
P.O. Box 7985
Madison, WI 53707-7985
Remember that all overseas claims must be filed within three years. Also, if you are filing a claim for care overseas, you will also be required to submit proof of payment.
Reviewing your TRICARE Claims Information Online
Register online to access secure functions on the TRICARE Overseas Program Website, including:
- Eligibility query*
- Other health insurance status/update
- Claim status
- Deductible/Out-of-pocket expense
- Customer Service
- Explanation of Benefits
*Note: Registering on the secure claims portal online does NOT affect your eligibility to participate in the TRICARE Philippine Demonstration. Eligibility is determined by your physical address listed on health care claims, regardless of the address listed in the Defense Enrollment Eligibility Reporting System (DEERS).