How do I file a claim?

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A: TRICARE For Life claims are usually submitted by the provider of the services performed, either electronically or by paper claim. However, beneficiaries can also submit claims for their medical services. They fill out the Patient's Request for Medical Payment (DD form 2642) and attach itemized bills.

Itemized bills must include the following: Name and address of the provider (usually located in the letterhead), Dates of Service, Procedure code or description of each service, Diagnosis code or description of diagnosis and Charges for each service.

Balance due statements or Explanations of Benefits (EOB) from Other Health Insurance (OHI) are not acceptable itemized bills, however the supporting Medicare and Other Health Insurance Explanation of Benefits (EOB) that corresponds to the charges filed are required. We need to know what all of your OHI plans paid in order to make our final determination.

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Other TRICARE Related Sites:

• TRICARE.mil
• TRICARE4U.com/Government
• TRICARE4U.com/Providers

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