Claims
If you have your prescription filled at a non-network pharmacy or if you have other health insurance with a prescription drug plan, you will need to submit a claim for reimbursement.
Prescription claims must be filed within one year of the date of service. To file a pharmacy claim, fill out a Patient's Request for Medical Payment (DD Form 2642) and include the following information with your claim. It is highly recommended that you submit an explanation of benefits (EOB) if you are filing a pharmacy claim when you have other health insurance (OHI).
The following information is required and cannot be handwritten on the EOB or the pharmacy printout:
- Date of fill
- Quantity
- Pharmacy name
- What you (the beneficiary) paid
- Drug name and strength
The following information is required and may be handwritten on the EOB or receipt:
- Number of day's supply
- Prescription number
- Pharmacy address
- Doctor's name or DEA number
- Pharmacist's signature (for retail pharmacy claims only; pharmacist signature not required for home delivery claims)
- Amount paid by the OHI or the retail price from the pharmacy
Claims Filing Addresses
In the U.S. or a U.S. Territory, file your claim with the pharmacy contractor:
Express Scripts
P.O. Box 52132
Phoenix, AZ 85072
In an overseas area (other than a U.S. Territory), file your claims with the overseas claims processor, at the appropriate address.
Overseas (all areas) Active Duty claims |
TRICARE Active Duty Claims P.O. Box 7968 Madison, WI 53707-7968 www.tricare-overseas.com |
Eurasia-Africa All non-active duty claims |
TRICARE Overseas Program P.O. Box 8976 Madison, WI 53708-8976 www.tricare-overseas.com |
Latin America & Canada All non-active duty claims |
TRICARE Overseas Program P.O. Box 7985 Madison, WI 53707-7985 www.tricare-overseas.com |
Pacific All non-active duty claims |
TRICARE Overseas Program P.O. Box 7985 Madison, WI 53707-7985 www.tricare-overseas.com |
Enrolled in the US Family Health Plan?
Remember, you will fill prescriptions through your US Family Health Plan's pharmacies, either onsite, network or mail-order, depending on what pharmacy options are available with your plan. You will not access military treatment facility pharmacies or TRICARE's other pharmacy options. To learn about your prescription drug coverage, enter your profile.
Last Modified: September 10, 2012
Contact
In the U.S. & U.S. Territories
Express Scripts
1-877-363-1303
Express Scripts Web site
Send claims to:
Express Scripts
P.O. Box 52132
Phoenix, AZ 85082
Overseas
www.tricare-overseas.com