TRICARE beneficiaries

Claims

Find information on how to file claims, appeals and grievances, check status of claims, how to view your electronic Explanation of Benefits (EOB) and more.

TRICARE Prime beneficiaries

In most cases, beneficiaries enrolled in TRICARE Prime will not need to file claims for healthcare services. There may be occasions, however, when you will need to pay for care and then file the claims yourself to receive payment. You will be reimbursed for TRICARE-covered services at the TRICARE-allowable amount, less any copayments, cost-shares or deductibles.

TRICARE Select beneficiaries

For beneficiaries enrolled in TRICARE Select, your provider may submit claims on your behalf, however, there may be occasions where you will be required to submit your own claims. Please check with your provider to find out if you need to submit a claim after receiving service.

Send Third Party Liability form to:

TRICARE East Region
Attn: Third Party Liability
P.O. Box 8968
Madison, WI 53707-8968

Fax # 608.221.7539

Download Third Party Liability form

Check status of claims

Our secure self-service tools allow you to view your claims information, send a secure message or chat with a representative.

Log in

Need to submit a claim?

number 1

Fill out a claim form or visit a military hospital or clinic.

Download the claim form

number 2

Complete all 12 blocks of the form and sign it.

How to fill out form

number 3

Attach required documents to the claim form.

Documents to include

When filing a claim, attach an itemized bill to the claim form. If you do not have an itemized bill, contact your provider to obtain a copy.

The itemized bill MUST contain the following information to expedite processing:

  • Provider’s name, address and phone number
  • Providers Tax Identification Number and the name of the provider who rendered the services
  • Date of service
  • Procedure codes performed (ex. 99213 – routine office visit)
  • Diagnosis code(s) (ex. J00 – common cold)
  • Changes for each service

To expedite your claim, please provide the following information. If you are unable to provide this information, you may experience a delay in processing.

  • Sponsor's ID number, if available, to ensure claim in processed correctly
  • Your address so that we can mail you a check and/or correspondence

number 4

Send in completed claim form and required documents.

Where to send claim form

Send claims to:

TRICARE East Region Claims
New Claims
P.O. Box 7981
Madison, WI 53707-7981

*Please note: If you need to file a claim for care you received overseas, you must file the claim with the overseas claims processor using the address for the area where you got the care. Learn more

Please note that you may be required to pay up front for services if you see a non-network TRICARE-authorized provider who chooses not to participate on the claim. In this case, TRICARE will reimburse you directly for the TRICARE-allowable charge minus any applicable deductible and cost-share. Remember that non-participating providers may charge you up to 15% above the TRICARE-allowable charge for services in addition to your cost-share and/or deductible. If you receive care while traveling, file TRICARE claims based on where you live, not where you received care. Be sure to keep a copy of the paperwork for your records.

Your Explanation of Benefits (EOB) is now available online

When you register for beneficiary self-service, you will have the ability
to view and print your TRICARE EOB, giving you access to your information
anytime. Remember, your EOB is an itemized statement that shows what action
TRICARE has taken toward your claims and is not a bill.

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