Claims

In most cases, providers will submit claims on behalf of TRICARE beneficiaries for healthcare services. However, there are some instances in which you can submit your own claim.


Beneficiaries can submit claims:

  • From a non-network provider for services performed in a doctor’s office, such as injections, immunizations, casting broken arms, etc.
  • For specialty pharmacy items administered at the doctor’s office. This might include immunizations or allergy shots.
  • Claims for Durable Medical Equipment (DME) and supplies.

Beneficiaries cannot submit:

  • Institutional charges (submitted by both network and non-network facilities) for services rendered at a facility and not a doctor’s office. They include ambulatory surgery, radiological services and lab work.
  • Claims for services performed by a network provider (EXCEPT DME claims). All network providers are REQUIRED to submit claims on your behalf to insure the best discount available.


Learn more

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.

Log in now