An official website of the United States government
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

News | May 11, 2021

How to File Your TRICARE Medical Claims

By TRICARE Communications

Are you getting ready for a doctor’s visit? One of the best ways you can prepare is by understanding your health care costs and if you need to pay anything out of pocket. When you see a TRICARE network provider, the provider will submit the claim on your behalf. But in some cases, like when you see a non-network provider, you may have to pay for health care services up front and file your own claim to get reimbursed. It’s important to know when you need to file a claim and how to do so.     
 
When should I file a medical claim?  
A claim is a request for payment from TRICARE that goes to your TRICARE contractor after you get a covered health care service. What determines whether or not you need to submit one is your TRICARE plan and provider. As a rule of thumb, you should expect to file your own claims if:  
If you’re unsure about how your claims will be filed, check with your provider to find out if you need to submit a claim after receiving care. As stated in the TRICARE Choices in the United States Handbook, “A provider must be TRICARE-authorized for TRICARE to pay any part of your claim.” If you have both Medicare and TRICARE, your claim will go to a Medicare contractor. You don’t need to file claims when using the US Family Health Plan.
 
How do I file a medical claim?
This process depends on where you received care. If you’re filing a stateside claim, submit your completed medical claim form (DD Form 2642) and supporting information to your TRICARE contractor. In the U.S. and U.S. territories, you must file claims within one year of service or the date of inpatient discharge.
 
For overseas claims, submit the claim form and proof of payment to the TOP claims processor. You must file overseas claims within three years of service or the date of inpatient discharge. The simplest way to file overseas claims is to do it online. You just need to log in to the beneficiary secure claims portal. If you need help, there are video tutorials to help guide you. If you’re enrolled in or live in the U.S. and receive care while traveling overseas, you’ll file your claim and proof of payment to the TOP claims processor.
 
Do you have TRICARE For Life? In most cases in the U.S. and U.S. territories, your provider files your health care claims with Medicare. After paying its portion, Medicare sends the claim to the TFL contractor to process, unless you have OHI. If you have OHI in addition to Medicare and TFL, you’ll need to file a claim with TRICARE for reimbursement of any remaining balance. As outlined in the TRICARE For Life Handbook, you’ll need to submit DD Form 2642, a copy of your provider’s bill, the corresponding Medicare Summary Notice, and OHI explanation of benefits to the TFL contractor.
 
For care received overseas, Medicare and the TFL contractor don’t process your claims. You should file your claim along with proof of payment with the TOP claims processor. Refer to the handbook for more details about filing TFL claims for care received overseas.
 
How do I check the status of my medical claim?
If you want to check the status of your medical claim, you can do so online. You must first register on your claims processor’s website. Once you do that, you’ll be able to see where your claim is in the process. You can also view your explanation of benefits, out-of-pocket expenses, and more after registering online. Keep in mind, most claims are processed within 30 days.
 
For more on how to file medical claims, visit Filing Claims. There, you can also learn about other types of claims, including pharmacy and dental. And be sure to listen to the “Get to Know TRICARE” podcast episode, “Help! How to File Claims,” for more helpful claim filing tips.
Images of Bayne-Jones Army Community Hospital and Bassett Army Community Hospital.

DHA Hospitals Earn Top Honors From the Leapfrog ...

News
Jan. 08, 2025

The Leapfrog Group has named two Defense Health Agency hospitals among the best in the nation. This shows the...
Read More
Map of the TRICARE West Region

Live in the West Region? Provide Your Payment In...

News
Jan. 06, 2025

Do you currently live in the West Region? Or, do you live in one of the six states that moved to the West...
Read More
Nurse wearing white scrubs answers phone.

Unlock Your Health Through the MHS Nurse Advice ...

News
Dec. 31, 2024

Do you know what to do when you or a family member feel sick, but it’s outside of business hours or it’s the...
Read More
Man and woman embrace each other.

Preview Four Changes Coming to TRICARE in 2025

News
Dec. 23, 2024

With the end of the year approaching, it’s a good time to consider your family’s healthcare needs for the...
Read More
Smiling pregnant woman sits down with a bandage on her arm

Get Vaccinated With TRICARE: RSV Immunizations O...

News
Dec. 20, 2024

Respiratory syncytial virus is a common but potentially dangerous respiratory illness. Immunizations are...
Read More
Man and woman holding a baby and smiling

Reminder: New TRICARE Regional Contracts in the ...

News
Dec. 19, 2024

Changes are coming to TRICARE’s regional contracts Jan. 1, 2025. These changes will affect you if you live in...
Read More
Service member works with pharmaceuticals.

New Prescription Refill System Coming to Militar...

News
Dec. 17, 2024

Do you get your prescriptions at a military pharmacy in the U.S.? You should know that the Defense Health...
Read More
Doctor uses a tablet.

Check the TRICARE Network Provider Directories A...

News
Dec. 11, 2024

If you get care outside of a military hospital or clinic, it’s important to understand your civilian provider...
Read More

Jan. 8, 2025

DHA Hospitals Earn Top Honors From the Leapfrog Group

The Leapfrog Group has named two Defense Health Agency hospitals among the best in the nation. This shows the military's strong focus on keeping patients safe and providing high-quality care.

Jan. 6, 2025

Live in the West Region? Provide Your Payment Information to TriWest Now

Do you currently live in the West Region? Or, do you live in one of the six states that moved to the West Region on Jan. 1? If you pay for your TRICARE coverage using a bank electronic funds transfer, credit card, or debit card, you must now securely give your recurring payment information to the West Region contractor, TriWest Healthcare Alliance.

Dec. 31, 2024

Unlock Your Health Through the MHS Nurse Advice Line

Do you know what to do when you or a family member feel sick, but it’s outside of business hours or it’s the weekend? TRICARE has a service called the Military Health System Nurse Advice Line that can help when you need healthcare guidance.

Dec. 23, 2024

Preview Four Changes Coming to TRICARE in 2025

With the end of the year approaching, it’s a good time to consider your family’s healthcare needs for the coming year. As you think about things like scheduling preventive care visits and knowing your 2025 TRICARE costs, you should also note some changes coming to TRICARE in 2025.

Dec. 20, 2024

Get Vaccinated With TRICARE: RSV Immunizations Offer Protection for High-Risk Individuals

Respiratory syncytial virus is a common but potentially dangerous respiratory illness. Immunizations are available to protect TRICARE beneficiaries who are considered high risk from RSV infection. These immunizations help protect older adults and newborns, who face higher risks from respiratory illness.

Dec. 19, 2024

Reminder: New TRICARE Regional Contracts in the U.S. in 2025

Changes are coming to TRICARE’s regional contracts Jan. 1, 2025. These changes will affect you if you live in the U.S. The key to a smooth transition is to take a few simple steps now, before the end of the year.

Dec. 17, 2024

New Prescription Refill System Coming to Military Pharmacies: What To Know

Do you get your prescriptions at a military pharmacy in the U.S.? You should know that the Defense Health Agency is upgrading to a new prescription refill system at military pharmacies. The new Interactive Voice Response system will help standardize refill notices.

Dec. 11, 2024

Check the TRICARE Network Provider Directories Ahead of 2025

If you get care outside of a military hospital or clinic, it’s important to understand your civilian provider options. TRICARE’s new regional contracts, which begin Jan. 1, 2025, will affect the TRICARE provider networks in the U.S. You’re now able to check the network provider directories for both the East Region and West Region.

Dec. 5, 2024

TRICARE Open Season Ends Dec. 10: Your Last Chance To Update Health Coverage for 2025

Time is running out to review and update your TRICARE health plan for 2025. TRICARE Open Season ends Tuesday, Dec. 10, marking your last day to enroll in a new plan or make changes to your health coverage.

Dec. 3, 2024

Reminder: TRICARE Regions Are Changing Jan. 1, 2025

There will be changes to the TRICARE regions in the U.S. on Jan. 1, 2025. While there will still be two TRICARE regions, six states currently in the East Region will move to the West Region. There are also some zip codes in four of these states that will be exceptions to the region changes.