If you are using TRICARE Prime, in most cases, you will not need to file claims for health care services. There may be times, however, when you will need to pay for care and then file the claims yourself to receive payment. You will be reimbursed for TRICARE-covered services at the TRICARE allowable amount, less any copayments, cost-shares, or deductibles.
 
If you are using the TRICARE Extra option, your provider will submit claims on your behalf. If you are using the TRICARE Standard option, you may be required to submit your own health care claims.
 
Claims must be filed within one year of the date of service or within one year of the date of an inpatient discharge. To file a claim, obtain and fill out a DD Form 2642 Patient’s Request for Medical Payment (link to Claims Form on HMHS Site). You can also visit a TRICARE Service Center (TSC) or a Military Treatment Facility (MTF). If you have claims questions, call Humana Military's toll-free number: 1-800-444-5445.
 
When filing a claim, 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 social security number.)
• 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.)

Be sure to complete all 12 blocks of the form correctly and sign it. Note: Providers submit inpatient facility claims.

You may be required to pay up front for services if you see a non-network TRICARE-authorized provider who chooses not to participate on the claim. In this case, TRICARE will reimburse you directly for the TRICARE allowable charge minus any applicable deductible and cost-share. Remember that nonparticipating providers may charge you up to 15 percent above the TRICARE allowable charge for services in addition to your cost-share and/or deductible.
 
Send claims to:
TRICARE South Region
Claims Department
P.O. Box 7031
Camden, SC 29020-7031
 
If you receive care while traveling, file TRICARE claims based on where you live, not where you received care. Be sure to keep a copy of the paperwork for your records.