How to File a TRICARE Claim (2026 Guide) | TRICARE.com

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## Quick answer In most cases, TRICARE providers (doctors, hospitals, pharmacies) file claims for you automatically. You generally only need to file a claim yourself if you see a non-participating provider, receive care overseas, or use a pharmacy that does not coordinate with Express Scripts.

Details

### When You Must File a Claim Most beneficiaries using **TRICARE Prime**, **TRICARE Select** (with network providers), or **TRICARE For Life** (TFL) will never need to file paperwork. However, you must manually file a claim if: * You see a non-network or "non-participating" provider who refuses to file for you. * You receive care while traveling outside your region or overseas. * You are forced to pay out-of-pocket for a prescription at a non-network pharmacy.

### How to File (By Region) Claims must be submitted to the contractor for the region where you received care, not necessarily where you live. For care received in 2026, submit to:

* **TRICARE East (Humana Military):** Submit via the Humana Military portal or by mailing DD Form 2642. * **TRICARE West (TriWest Healthcare Alliance):** Submit via the TriWest self-service portal. Note that effective January 1, 2025, TriWest replaced Health Net Federal Services (HNFS) as the regional contractor. * **TRICARE Overseas (International SOS):** Claims are often filed via the TOP beneficiary portal; specific rules apply based on whether you are active duty or a retiree. * **Pharmacy (Express Scripts):** Use the Express Scripts member portal for drug-related reimbursement.

### Required Documentation To ensure your claim is not denied, you must include: 1. **DD Form 2642:** The "Patient’s Request for Medical Payment." 2. **Itemized Bill:** Must include the provider's name, Tax ID (NPI), address, date of service, CPT codes (procedure codes), and ICD-10 codes (diagnosis codes). 3. **Proof of Payment:** If you paid the provider in full. 4. **Other Health Insurance (OHI) Explanation of Benefits (EOB):** If you have other insurance, TRICARE is the secondary payer. You must file with your primary insurance first and include their EOB with your TRICARE claim.

### Deadlines For 2026, the strict deadlines for filing are: * **In the U.S. and U.S. Territories:** Claims must be filed within **one year** of the date of service. * **Overseas:** Claims must be filed within **three years** of the date of service.

## Who this affects * **Active Duty Family Members (ADFMs):** When seeing non-network specialists. * **Retirees and their families:** Using TRICARE Select or receiving care from non-participating providers. * **TRICARE Reserve Select (TRS) / TRICARE Retired Reserve (TRR) members:** If using non-network providers. * **Travelers:** Anyone receiving emergency care while outside their home region or the United States.

## Sources * **TRICARE.mil:** [Filing Claims](https://www.tricare.mil/claims) * **Humana Military (East):** [Claims Submission](https://www.humanamilitary.com/beneficiary/claims/) * **TriWest (West):** [Provider & Beneficiary Portals](https://www.triwest.com/) * **Express Scripts:** [Pharmacy Claims](https://militaryrx.express-scripts.com/claims)