Forms

 

Accessing TRICARE DD forms:

Due to security settings, you may not be able to view certain DD forms in your web browser. If you encounter an issue viewing a form in your web-browser, right-click and select "Save as" to save to your computer. You can then open the form using your system's default program for viewing PDFs. You can also try accessing the form directly from the official DoD forms site.


Claims Billing and enrollment HIPAA Miscellaneous
New claim submissions

For care received starting Jan. 1, 2025:
Humana Military Claims
PO Box 202146
Florence, SC 29502-2146

 

For care received through Dec. 31, 2024
TRICARE EAST
Attn: New Claims
PO Box 7981
Madison, WI 53707-7981
Fax: (608) 327-8522

Third Party Liability (TPL) submissions

For care received starting Jan. 1, 2025:
Humana Military Claims
Attn: Third Party Liability (TPL)
PO Box 202152
Florence, SC 29502-2152.
Fax: (877) 489-0041

 

For care received through Dec. 31, 2024:
TPL form and TPL requested medical record submissions:
TRICARE East Region
Attn: Third Party Liability (TPL)
PO Box 8968 Madison, WI 53707-7539
Fax: (608) 221-7539

General release of information authorization requests

General release of information authorizations should be completed online through beneficiary self-service. Sensitive diagnosis and revocation options are not available in self-service at this time.

Log in or register to submit a general release of information request.