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. Reimbursements are subject to applicable deductibles, cost-shares, and copayments.
• 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 by mail.

Required Information With Your Online Claim

To file your claim file a claim online, you’ll need:

• An Express Scripts account
• Your prescriber’s information
• A photocopy of your pharmacy receipt
• Your pharmacy’s phone number

Required Information With Your Claim

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

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 85082

In an overseas area (other than a U.S. territory), you’ll file your claim with the overseas claims processor. File a claim through the overseas secure claims portal or at the appropriate address.