Pharmacy Claims

You will need to file a claim for reimbursement if:

• You get your prescription filled at a non-network pharmacy, or
• You have other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance." with pharmacy benefits

You must file your claim within one year of the date of service.   

Required Info with Your Claim

• Fill out a Patient’s Request for Medical Payment (DD Form 2642).
• You must send the form and the following information with your claim.
• If you have other health insurance, you should send an explanation of benefits (EOB).

Claims Filing Addresses

In the U.S. or a U.S. Territory, file your claim with the pharmacy contractor:

Express Scripts, Inc.
P.O. Box 52132
Phoenix, AZ 85072-2132

In an overseas area (other than a U.S. Territory), file your claims with the overseas claims processor, at the appropriate address.