How to File a TRICARE Claim: 2026 Guide | TRICARE.com

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## Quick answer In most cases, your doctor files TRICARE claims for you. You only need to file a claim manually if you see a non-participating provider, receive care overseas, or use a pharmacy that is not in the Express Scripts network. To file, you must submit **DD Form 2642** along with itemized receipts to your regional contractor (Humana Military in the East or TriWest in the West).

Details

### When You Must File a Claim Under TRICARE Prime and Select, network providers are contractually required to file claims on your behalf. You generally only need to take action if: * You see a **non-participating, non-network provider** who refuses to file for you. * You receive care **outside the United States** (managed by International SOS). * You use an **out-of-network pharmacy** (managed by Express Scripts). * You are covered by **Other Health Insurance (OHI)** and must show TRICARE what your primary insurance paid before they cover the remainder.

### The Required Form All medical claims require **DD Form 2642** (Patient’s Request for Medical Payment). You must attach: 1. An itemized bill from the provider. 2. Diagnosis descriptions or codes (ICD-10). 3. Procedure codes (CPT). 4. The provider’s Tax ID or National Provider Identifier (NPI). 5. An "Explanation of Benefits" (EOB) if you have other primary insurance.

### Where to Send Claims (2026 Regions) As of early 2025, the TRICARE West contract transitioned to TriWest Healthcare Alliance. Ensure you are sending claims to the correct regional address:

* **TRICARE East (Humana Military):** TRICARE East Region, Claims Department, P.O. Box 7071, London, KY 40742-7071. * **TRICARE West (TriWest Healthcare Alliance):** TRICARE West Region, Claims Department, P.O. Box 202106, Florence, SC 29502-2106. * **TRICARE Overseas (International SOS):** Varies by specific region (Eurasia-Africa, Latin America, Pacific). Usually submitted via the TOP Beneficiary Secure Claims Portal. * **Pharmacy (Express Scripts):** Express Scripts, Inc., P.O. Box 52132, Phoenix, AZ 85072.

### Filing Deadlines Timely filing is critical to getting reimbursed: * **United States and US Territories:** Claims must be filed within **one year** of the date of service or date of discharge for inpatient care. * **Overseas:** Claims must be filed within **three years** of the date of service.

### Costs and Reimbursements If you see a non-participating provider, you may have to pay the full bill upfront and wait for TRICARE to reimburse you. Keep in mind that for 2026, non-participating providers can legally charge up to 15% above the TRICARE-allowed amount (the "limiting charge"). TRICARE will only reimburse up to the allowed amount; you are responsible for the 15% difference.

## Who this affects * **TRICARE Select Beneficiaries:** More likely to see out-of-network providers. * **TRICARE Prime Beneficiaries:** Only if they use the Point-of-Service option or emergency care from a non-network provider. * **Retirees and Family Members:** Especially those with Other Health Insurance (OHI). * **National Guard and Reserve:** Those using TRICARE Reserve Select (TRS). * **Overseas Travelers:** Any beneficiary receiving care while outside the U.S.

## Sources * **TRICARE.mil (Filing Claims):** https://www.tricare.mil/claims * **Humana Military (West Region):** https://www.humanamilitary.com/beneficiary/claims * **TriWest Healthcare Alliance (West Region):** https://www.triwest.com/en/beneficiary/ * **Express Scripts (Pharmacy Claims):** https://militaryrx.express-scripts.com/claims