TRICARE, Your Military Health Plan

In This Section:

• Cancer Clinical Trials
• Questions to ask Your Doctor
• Costs
• Chiropractic Care
• Designated Locations
• Combat-Related Special Compensation Travel Benefit
• Before Traveling for Specialty Care
• Requesting Reimbursement
• Computer and Electronic Accomodations Program (CAP)
• Continued Health Care Benefit Program (CHCBP)
• Purchasing CHCBP Coverage
• Getting Care Through the CHCBP
• Filing CHCBP Claims
• Extended Care Health Option (ECHO)
• Who May Qualify
• Benefits
• Costs and Coverage Limits
• ECHO Home Health Care
• Autism Services Demonstration
• Foreign Force Member Health Care Option
• Line of Duty/Notice of Eligibility
• Pre-activation Benefit for National Guard and Reserve
• Medical Benefits
• Dental Benefits
• Transitional Assistance Management Program (TAMP)
• TRICARE Prime Options
• TRICARE Standard Options
• Dental Options
• Transitional Care for Service Related Conditions
• TRICARE Philippine Demonstration
• Philippine Demonstration Designated Areas
• Getting Care under the Demonstration
• Submitting a Waiver Request
• Health Care Costs under the Demonstration
• Filing Health Care Claims under the Demonstration
• TRICARE Plus
• Women, Infants and Children (WIC) Overseas
• Offices

Filing Health Care Claims Under the Demonstration

One of the main benefits of the TRICARE Philippine Demonstration is that Approved Providers will file claims on your behalf and you will receive an explanation of benefits (EOB).

• The EOB will tell you the amount you will pay (deductible and cost share).
• After receiving your EOB, you will finalize payment directly with your provider.

Give your provider your physical home mailing address so he/she can file the claims. P.O. boxes and Retired Activities Office boxes cannot be used.

The only time you should have to file your own claims under the demonstration is if you requested and received a waiver from International SOS to get care from a non-Approved Demonstration Provider.  In this scenario, follow the steps below to file a claim:

1. Download and complete the Patient's Request for Medical Payment (DD Form 2642). 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) 
2. Fill out all 12 blocks of the form correctly and sign it. (See Completing the Claim Form) 
3. Make a copy of the paperwork for your records.
4. Mail your completed claim form to:

TRICARE Overseas Program
P.O. Box 7985
Madison, WI 53707-7985

Remember that all overseas claims must be filed within three years. Also, if you are filing a claim for care overseas, you will also be required to submit proof of payment.

Reviewing your TRICARE Claims Information Online
Register online to access secure functions on the TRICARE Overseas Program Web site, including:

• Eligibility query*
• Other health insurance status/update
• Claim status
• Deductible/Out-of-pocket expense
• Customer Service
• Explanation of Benefits

*Note: Registering on the secure claims portal online does NOT affect your eligibility to participate in the TRICARE Philippine Demonstration. Eligibility is determined by your physical address listed on health care claims, regardless of the address listed in the Defense Enrollment Eligibility Reporting System (DEERS).

Last Modified:September 27, 2012