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.

*If you have prescriptions filled at a non-network pharmacy, you’re using the point-of-service option. You’ll receive a partial reimbursement after you’ve met the point of service deductible.

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.

Explanation of Benefits (EOB)

Each time you get a prescription filled at a military pharmacy, a network pharmacy, or through home delivery, Express Scripts records your claim on an explanation of benefits.

You can login or create an account with Express Scripts to view your statement online. You’ll get an email once a month telling you that you have an updated EOB. 

• If you don’t have a valid email in your Express Scripts online profile, you’ll get a paper EOB in the mail.
• You can change your preference to request a paper EOB at any time.
• Paper EOBs are delivered quarterly (every three months).