Pharmacy Claims

When should I file a claim?

You’ll need to file a claim for reimbursement if:

  • You get your prescription filled at a non-network pharmacy. This is using the point-of-service option. You’ll receive a partial reimbursement after you’ve met the point-of-service deductible.
  • 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.

How Can I File a Claim?

You may be able to file a claim online or via mail (paper copy).

Required Info with Your Online Claim

To fill out your claim online, you’ll need:

  • Your prescriber’s information.
  • A photocopy of your pharmacy receipt.
  • Your pharmacy’s phone number.

Required Info with Your Claim

CAN'T be Handwritten on the EOB or Pharmacy Receipt CAN be Handwritten on the EOB or Pharmacy Receipt
  • Date of fill
  • Quantity
  • Pharmacy name
  • What you (the beneficiary) paid
  • Drug name and strength
  • Number of day’s supply
  • Prescription number
  • Pharmacy address
  • Doctor’s name or DEA number
  • Pharmacist’s signature (for retail pharmacy claims only)
  • Amount paid by the other health plan or the retail price from the pharmacy

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.

Active Duty
All Overseas Areas
TRICARE Active Duty Claims
P.O. Box 7968
Madison, WI 53707-7968
Non-active duty
TRICARE Overseas Program
P.O. Box 8976
Madison, WI 53708-8976
Latin America & Canada
Non-active duty
TRICARE Overseas Program
P.O. Box 7985
Madison, WI 53707-7985
Non-active duty
TRICARE Overseas Program
P.O. Box 7985
Madison, WI 53707-7985

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 (EOB).

You can login or create an account with Express Scripts to view your EOB 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).

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Last Updated 9/3/2019