Appeals and Grievances

Appeals

File an Appeal

The appeals process can differ based on whether the denial relates to medical necessity or other facts.

Is There a Deadline to File an AppealThe action you take if you don’t agree with a decision made about your benefit.?

You must file your appeal by certain deadlines.

Expedited Appeals: Do you need a quick review of a denial? Submit it within three days of getting the denial letter.

Regular Appeals: For a standard review, you have 90 days from the denial date to file.

Who Can File?

You or someone you choose can file an appeal. For specific information about filing an appeal in your region, contact us.

Submitting an Appeal

https://www.humanamilitary.com/appeal
(Preferred method)

OR

Fax: 877-850-1046

OR

TRICARE East Appeals
PO Box 740044
Louisville, KY 40201-7444

Grievances

What is a GrievanceYou can file a grievance when:
- You have a complaint about the quality of care you received,
- A provider or facility behaved inappropriately, or
- You have any other non-appealable issue.
The grievance may be against any member of your health care team. This includes your TRICARE doctor, your contractor, or a subcontractor.?

You can file a grievance when:

  • You have a complaint about the quality of care you received,
  • A provider or facility behaved inappropriately, or
  • You have any other non-appealable issue.

The grievance may be against any member of your health care team. This includes your TRICARE provider, your contractor, or a subcontractor.

A grievance is a written complaint about issues that can’t be appealed. This includes concerns about health care quality, access, or provider behavior.

Who Can File?

Anyone involved with TRICARE, including beneficiaries and guardians, can file a grievance.

Submitting a Grievance

To file a grievance, write about your concern and include:

  • Beneficiary's name, address, and phone number
  • Date of birth
  • Sponsor's Social Security number 
  • Date, time, and location of the event
  • A description of your concern
  • Any supporting documents

Send your grievance by mail to:

TRICARE East Grievances
8123 Datapoint Drive, Suite 400
San Antonio, TX 78229 

Resolution Timeline

TRICARE East will investigate and resolve grievances within 60 days. You’ll receive a notification once they complete the review.  

Last Updated 4/23/2025