Medical Claims
Reading Your Medical Explanation of Benefits
A TRICARE explanation of benefits isn’t a bill. It’s a summary of the services and items you received. It tells you how much your provider billed, the approved amount TRICARE paid, and how much you may have to pay to the provider.
- Your TRICARE contractor creates an EOB for each of your claims.
- You may get one EOB statement detailing all the claims you had in the past month or quarter. This is called a summary EOB.
- You should keep your EOB statements with your health insurance records.
If you live in the East Region or West Region
You’ll get all your medical EOBs online. You must create an account on your regional contractor’s beneficiary portal to view your EOBs.
Would you like to get paper copies? Call your contractor to opt in to paper EOBs. You’ll get monthly summary EOBs instead of a separate EOB for each claim. If you didn’t get any care during that month, you won’t get a summary EOB.
You can change your preference at any time by calling your regional contractor or logging in to their portal.
Important: If you don’t create an account on your regional contractor’s beneficiary portal, you won’t get any medical EOBs unless you request paper summary EOBs.
If you live overseas
You’ll get all your medical EOBs online if you have an email on file or an account on the contractor’s secure claims portal. If you don’t have an account or submit a request, you’ll get paper EOBs each time a claim is processed.
You can change your preference at any time by calling the contractor or logging in to their portal.
If you have TRICARE For Life
You’ll get paper copies of your EOBs. You’ll get monthly summary EOBs, instead of a separate EOB for each claim. (Note: If you have claims without any beneficiary liability – meaning you don’t owe anything – you’ll get these EOBs once every 90 days.)
Want to go paperless? Create an account with the TRICARE For Life contractor’s beneficiary portal and update your mailing option. Instead of getting monthly EOBs, you’ll get an EOB when your claim has processed.
You can change your preference at any time by calling the contractor or logging in to their portal.
Medical Claims Addresses
- For care received in the U.S. or U.S. territories, send your claims to the claims address for the region where you live.
- For medical care received in all other overseas areas, send your claims to the claims address where the care was received. You may also be able to file overseas claims online.
| Plan | Location | Claims Address |
|---|---|---|
|
TRICARE Prime |
East Region |
TRICARE East Region Claims Fax: 877-489-0007 |
|
West Region |
West Region Claims Submission Fax: 877 989-0070 |
|
|
TRICARE Prime Overseas |
Overseas (active duty service members) | TRICARE Active Duty Claims P.O. Box 7968 Madison, WI 53707-7968 |
| Eurasia-Africa (all other beneficiaries) | TRICARE Overseas Program P.O. Box 8976 Madison, WI 53708-8976 |
|
| Latin America & Canada (all other beneficiaries) | TRICARE Overseas Program P.O. Box 7985 Madison, WI 53707-7985 |
|
| Pacific (all other beneficiaries) | TRICARE Overseas Program P.O. Box 7985 Madison, WI 53707-7985 |
|
| TRICARE For Life (TRICARE and Medicare) |
U.S. & U.S. territories | WPS TRICARE For Life P.O. Box 7890 Madison, WI 53707-7890 |
| All other overseas areas | Use the overseas claims addresses listed above. | |
| TRICARE Prime Demo | Atlanta and Tampa locations | CareSource Attn: Claims Department P.O. Box 608 Dayton, OH 45401-0608 |
| Continued Health Care Benefit Program | All locations |
CHCBP Claims Fax: 877-489-0007 |
| Claims for NOAA members | All locations | U.S. Department of Commerce Office of the General Counsel Office of the Assistant General Counsel for Finance and Litigation General Litigation Division 1401 Constitution Ave. NW, Room 5890 Washington, DC 20230-0001 |
Filing and Checking Claims Status
Follow the steps below to file and check the status of your claims.
Tips:
- Keep a copy of all paperwork for your records.
- If you need help, call your regional contractor.
Are you overseas? If yes, then you can file your claims online.
Step 1: Fill out the TRICARE claim form
- Download the Patient’s Request for Medical Payment (DD Form 2642).
- Fill out all 12 blocks of the form completely.
- Sign the form.
Step 2: Include a copy of the provider’s bill
Attach a readable copy of the provider’s bill to the claim form. Make sure it includes the following:
- Sponsor’s Department of Defense Identification Number or DOD Benefits Number. (Eligible former spouses should use their own DOD ID or DBN.)
- 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 isn’t on the bill, be sure to fill out section 8a on the claim form.)
Note: You must send proof of payment with all overseas claims, including claims for care received when traveling overseas.
Step 3: Submit the claim
- Mail your completed claim form to the claims address for your claims processor.
- If filing a claim overseas, you can submit your claim online.
Step 4: Check the status of your claims
To keep track of your claims online, you’ll need to register on your claim processor’s site:
- East Region
- West Region
- Overseas Region
- TRICARE For Life (U.S. and U.S. territories only)
Once registered, you can also:
- Look up your deductibles and out-of-pocket expenses.
- Update your other health insurance information.
- View your explanations of benefits.
Completing a Claim Form
It’s important to provide all necessary information on the claim form. The items below are critical to process your claim.
Once you complete your claim form, keep a copy of it and all original invoices and receipts.
| Box 1: Patient’s Name | Enter the patient’s last name, first name, and middle initial as they appear on his or her Uniformed Services ID card. Don’t use nicknames. |
|---|---|
| Box 2: Patient’s Telephone Number | Enter the patient’s daytime and evening telephone numbers. Include area codes. |
| Box 3a: Patient’s Address | Enter the complete address of the patient’s place of residence at the time of service. |
| Box 3b: State/Country of Physical Location Where Services Were Rendered (overseas claims only) | Identify the state or country of where services were rendered. |
| Box 4: Patient’s Relationship to Sponsor | Check the box that indicates the patient’s relationship to sponsor. If “Other” is checked, indicate how the patient is related to the sponsor. |
| Box 5: Patient’s Date of Birth | Enter the patient’s date of birth. |
| Box 6: Patient’s Sex | Check the box for either male or female patient. |
| Box 7: Patient’s Condition | Check boxes to indicate if patient’s condition is accident related, work related, or both. If accident or work related, the patient is required to complete a Statement of Personal Injury - Possible Third Party Liability form (DD Form 2527). |
| Box 8a: Describe Illness, Injury, or Symptoms That Required Treatment, Supplies, or Reason for Medication | Describe the patient’s condition for which treatment was provided (for example, broken arm, appendicitis, eye infection). If the patient’s condition is the result of an injury, report how it happened (for example, fell on stairs at work, car accident). If you know the diagnosis code, you can include it. If you don’t know the diagnosis code, be descriptive. |
| Box 8b: Was Patient’s Care | Check the box to indicate where the care was given. |
| Box 9: Sponsor’s Name | Enter the sponsor’s name. If the sponsor is the patient, enter “same.” |
| Box 10: Sponsor’s Social Security Number or DOD Benefits Number | Enter the Sponsor’s Social Security number or Department of Defense Benefits Number. Former spouses should use their own SSN. The DBN is the 11-digit number on the back of the Uniformed Services ID card. |
| Box 11: OHI Coverage | Indicate if you’re covered by any other health insurance plan to include coverage available though other family members. (Don’t report supplemental health insurance.) |
| Box 12: Signature of Patient or Authorized Person Certifies Correctness of Claim and Authorizes Release of Medical or Other Insurance Information |
|
| Box 13: Payment Currency | If this is a claim for care received overseas, indicate if you want payment in the local currency. (Payment is available only in some local currencies.) |
Filing Claims Overseas
If you need to file a claim for care you received overseas, you’ll file the claim with the overseas claims processor using the claims address for the area where you got the care.
Or, you can file your claims online. Watch International SOS’ video tutorials to help guide you through the process.
You must send proof of payment with all overseas claims, including claims for care received when traveling overseas.
Did you pay your provider directly? Write the amount paid at the top of the TRICARE claim form, TRICARE DoD/CHAMPUS Medical Claim Patient’s Request for Medical Payment form (DD Form 2642). Also include the following:
- An itemized bill or invoice (a balance due statement isn’t acceptable)
- Diagnosis describing why the medical care is needed
- An explanation of benefits from your other health insurance, such as travel insurance or an employer-sponsored health insurance (if applicable). Supplemental insurance plans don’t qualify as OHI.
Send any of the following items along with the provider’s invoice or itemized bill as proof of payment:
- Copy of the check showing the service provider’s name in the “pay to the order of” field and signed by the patient or sponsor
- Credit card receipt
- Electronic funds transfer receipt
- Bank statement documenting the dispersal of funds with provider name (matching the claim submission) or cash withdrawal equal to or greater than the paid amount
- Receipt, itemized bill, or statement by provider’s office stamped PAID
- Invoice for pharmaceuticals dispensed on an outpatient basis with a list of prescribed drugs
Note: Due to Turkish law, an invoice is an acceptable proof of payment when the claim is for care rendered by a provider in Turkey.
You may need to complete additional attestations for your claim to process.
Are you bundling more than one claim on a single claim form? You must submit a proof of payment for each service. We’ll review each individual claim separately. We’ll return any items that don’t have proof of payment for further documentation.
Do you have questions about proof of payment, submitting claims, or the status of a claim you’ve already submitted? You can email tricareoverseas@top.internationalsos.com or call your TRICARE Overseas Regional Call Center.
| Eurasia-Africa | +44-20-8762-8384 877-678-1207 (toll-free from U.S.) |
|---|---|
| Latin America & Canada | +1-215-942-8393 877-451-8659 (toll-free from U.S.) |
| Pacific | +65-6339-2676 877-678-1208 (toll-free from U.S.) |
Tips for Filing Claims
Claims may be delayed or denied because the claim form wasn’t filled out correctly or all the information wasn’t provided. Here are some tips to help you file your claims correctly:
| Keep the Defense Enrollment Eligibility Reporting System updated. | Incorrect information in DEERS could cause your TRICARE claim to be denied. Update DEERS. |
|---|---|
| Use the right form. | File medical claims on Patient’s Request for Medical Payment (DD Form 2642). |
| Fill in all 12 blocks. | Include the sponsor’s Social Security number or Department of Defense Benefits Number, your home address and phone number, and any other pertinent information needed. |
| Use the right diagnosis code. | Your provider should give you a diagnosis code for all services he or she provided. Include that code with the description in Box 8a. |
| Sign the claim form. | Claims submitted without a signature will be denied payment. |
| Notify TRICARE if there’s a third party involved. | If you were hurt in an accident and someone else may bear responsibility, you have to let TRICARE know by submitting Statement of Personal Injury-Possible Third Party Liability (DD Form 2527) along with your medical claim form. |
| File claims with other health insurance first. | TRICARE pays second to most other health insurance programs. When you get payment from your OHI, you can then file a claim with TRICARE. Include a copy of your explanation of benefits from your OHI with your TRICARE claim. |
| Make copies. | Keep copies of everything you submit to the claims processor. |
| Use the right claims address. | Send your claim forms to the correct address to avoid delays. |
| File claims on time. | Claims must be filed within one year of the date of service, or within one year of the date of an inpatient discharge or three years if overseas. But you’re encouraged to send your claim form to TRICARE as soon as possible after you receive care. |
| Submit each claim separately. | Filing multiple claims together could cause confusion. |
Denied Claims
A claim may be denied for several reasons. Many times, it's a simple error that you (if you submitted the claim) or your provider made when submitting the claim.
- If your claim is unpaid or denied, contact your claims processor. See the right side of page for contact information.
- If your claim was denied because of incorrect filing, correct the error and resubmit the claim to your claims processor.
- If you believe your claim was inappropriately denied, in whole or in part, you or another appropriate party may file an appeal.
For help at any time, contact your claims processor.
Last Updated 9/30/2026
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