You may have to submit your own pharmacy claims if you fill prescriptions at a non-network pharmacy or if you have other health insurance (OHI) (See "Coordinating Benefits with Other Coverage"later in this section.) Before reimbursement is granted for non-network pharmacy claims, you must meet an annual TRICARE deductible.
Claims must be filed within one year of the date of service. To file a pharmacy claim, obtain and fill out a Patient’s Request for Medical Payment (DD Form 2642). Prescription claims require the following information for each drug:
Name of the patient
Name, strength, date filled, days' supply, quantity dispensed, and price of each drug
National Drug Code (NDC), if available
Prescription number of each drug
Name and address of the pharmacy
Name and address of the prescribing physician
You can download forms and instructions at the TRICARE Web Site. Click on “TRICARE Claim Form (DD Form 2642)” under “Downloads” in the right-hand navigation column. Call 1-866-DoD-TRRX (1-866-363-8779) with questions about filing a pharmacy claim.
TRICARE Reserve Select (TRS) claims for services received overseas are processed under the TRICARE South Region contract. Wisconsin Physicians Service (WPS) has been subcontracted by Humana Military to provide claims processing services for all overseas TRICARE areas. For information and assistance in filing claims for services received overseas, visit the WPS Web site.
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 Patient’s Request for Medical Payment (DD Form 2642). You can download forms and instructions at the TRICARE Web Site or from your local TSC and a TRICARE Point of Contact (POC).
When you fill out patient information and claim forms, be sure to use your overseas APO or FPO mailing address and attach photocopies of fully itemized bills from the provider showing the cost for each service or supply provided. Using a Continental United States (CONUS) address will result in payment problems.
Send claims to the address listed for your overseas region in Figure 3.2. Keep a copy of your paperwork for your records.
WPS—Overseas Claims
P.O. Box 8976
Madison, WI 53708-8976
WPS—Overseas Claims
P.O. Box 7985
Madison, WI 53707-7985
WPS—Overseas Claims
P.O. Box 7985
Madison, WI 53707-7985
TRICARE Point of Contact Program
The TRICARE Overseas Program (TOP) POC Program is a liaison service that assists beneficiaries and host-nation providers in remote locations in filing medical and TRICARE Dental Program claims. This ensures timely overseas claims filing and payment, and continued beneficiary access to quality host-nation health care. To locate a POC near you, contact the TRICARE Area Office or an overseas dental treatment facility in your area.
