Related Benefits Articles

  • overview redstone family
    TRICARE Standard TAMP At-A-Glance
    If you are eligible for the Transitional Assistance Management Program (TAMP) and do not live in an area in which a Prime progr...
  • Staff Sgt. Lorylee Willis injects Pediarix into two-month old Sophia Grace Pellegrino, as her father, Dr. (Capt.) Peter Pelligrino, 71st MDG pediatrician, looks on. (U.S. Air Force photo by Staff Sgt. Brian Hill)
    TRICARE Standard Overview
    TRICARE Standard Extra are very similar. The main difference is which provider you can use. This page explains TRICARE Standard.
  • Doctor and Patient
    TRICARE Prime Coverage Details
    TRICARE Prime is a managed care program for servicemembers and their families.
  • Doctor speaking with patient.
    TRICARE Extra Overview
    TRICARE Extra requires you to use a TRICARE network provider but it offers the lowest cost of all plans.
  • College student using a laptop.
    TRICARE Young Adult Standard
    TRICARE Young Adult Standard is similar to the TRICARE Standard and Extra program

Most Popular TRICARE Benefits Articles

  • Tricare
    TRICARE Benefits Overview
    Do you understand your TRICARE benefits? Find the TRICARE coverage plan that best suits your family's needs.
  • Military families don’t need extraordinary acts of thanks -- just a helping hand. U.S. Army MWR photo
    Defense Enrollment Eligibility Reporting System (DEERS)
    DEERS is a computerized database of military sponsors, families and others worldwide who are entitled to TRICARE benefits.
  • Doctor with an elderly patient.
    TRICARE for Life
    If you have Medicare part A & B, TRICARE for life can pay your Medicare copay.
  • Doctor examines servicemember
    The TRICARE Prime Program
    TRICARE Prime is a managed service healthcare program for servicemembers, reservists, dependents, and some retirees.
  • Retiree Health Fair 600x400
    TRICARE for Retirees
    TRICARE For Life (TFL) is a Medicare wraparound coverage for TRICARE beneficiaries who have Medicare Parts A and B.

Understanding the TRICARE Claims Process

Whether you submit a claim form depends on the type of TRICARE program option and provider you choose to use.

TRICARE Prime/Prime Remote enrollees

  • If you use network providers, providers file claims on your behalf.
  • If you use a non-network provider or require emergent/urgent care outside your region, the provider may file claims on your behalf or require you to pay out-of-pocket and file your own paper claim for reimbursement.

When you use network providers, the providers file claims on your behalf.

TRICARE Standard
The provider may file claims on your behalf or require you to pay out-of-pocket and file your own paper claim for reimbursement.
  • Participating providers agree to accept TRICARE payment and any cost share as payment in full.
  • Non-participating providers do not agree to accept the TRICARE-determined allowable charge as the total charge for services; they can bill you up to 15% more of the TRICARE allowable charge. TRICARE will send reimbursement to you and you, in turn, pay the provider.

Your valid uniformed services ID card serves a proof of eligibility for TRICARE coverage. You are responsible for appropriate copays, cost shares, and deductibles.

Click here to select and download the proper TRICARE Claims Forms.

For general information about TRICARE, call one of the many toll-free TRICARE information lines found at the TRICARE Contact Us web page.

Military News App by

Download the new News App for Android on Google Play or for Apple devices on iTunes!

© 2016 Military Advantage