FALLS CHURCH, Va. –
If you have
TRICARE For Life, you’ll get health care from
Medicare providers. There are certain times you may need to file your own claims with
WPS Government Services, the TFL contractor. Here’s what you need to know about when to file claims when you have Medicare and TFL.
“Always prepare to show your Medicare card along with your military ID card at any medical appointment for a smooth claims process,” said Anne Breslin, TRICARE For Life program manager, TRICARE Health Plan, at the Defense Health Agency.
Who files my claims?
In most cases, your provider files your health care claims with Medicare first. Medicare pays its share and sends the claim to WPS for processing and payment of TRICARE’s portion of the claim.
Sometimes, you’ll need to file your own claim with WPS. This happens when:
What you need for filing claims
When you file a claim, include:
Required information on bills
Make sure your provider’s bill shows:
- Your name
- Provider’s name and address
- Date and place of service
- Description of services
- Charges for each service
- Diagnosis
Filing deadlines
You have one year from the date of service to file claims in the U.S, as described in the
TRICARE For Life Handbook. Send claims to the
WPS mailing address.
Filing claims overseas
When you get care overseas, TRICARE pays first (unless you have OHI). Medicare doesn’t pay for overseas care.
You must submit proof of payment with all overseas claims. This can be:
- Credit card receipts
- Canceled checks
- Credit card statements
- Provider invoices showing payment
File overseas claims where you received care. You have three years from the date of service to file these claims.
How do I get help?
Remember: Seeing Medicare participating providers gives you the lowest out-of-pocket costs. To learn more, visit TRICARE For Life.
Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions to get benefit updates, news, and more.