TRICARE Claims How to file a TRICARE Claim
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.
TRICARE Extra
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. For more information
on benefits and payments, please visit the TFL 2005 Benefits
and Payments Summary to assist you with identifying who pays
for what under TRICARE For Life (TFL).
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