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 (EOBs) 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 healthcare provider may submit claims on your behalf, however, there may be occasions where you will be required to submit your own healthcare 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 correctly and sign it.

How to fill out form correctly

number 3

Attach required documents to the claim form.

Documents to include

When filing a claim, attach a readable copy of the provider’s bill to the claim form, making sure it contains the following:

  • Sponsor’s Social Security Number (SSN) (eligible former spouses should use their SSN)
  • Provider’s name and address (if more than one provider’s name is on the bill, circle the name of the person who treated you)
  • Date and place of each service
  • Description of each service or supply furnished
  • Charge for each service
  • Diagnosis (if the diagnosis is not on the bill, be sure to complete block 8a on the form)

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 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 (EOBs) 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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