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Theresa Wright, 28th Medical Support Squadron pharmacy technician, counts pills to correctly fill a prescription on Ellsworth Air Force Base, S.D., May 22, 2012. The 28th MSS completes an average of 510 prescriptions a day. (U.S. Air Force photo by Airman 1st Class Alystria Maurer/Released)
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Filing a Pharmacy Claim

In some cases, beneficiaries will have to submit a claim to get reimbursement for their prescriptions. Educating beneficiaries on how to file claims will increase their understanding of the claims process as well as provide them with a resource to help them complete their claims.

Talking Points

  • To file a pharmacy claim, complete the TRICARE DOD/CHAMPUS Claim Form-Patient's Request for Medical Payment (DD Form 2642) and submit it, along with any other required information, to Express Scripts.
  • Occasionally, TRICARE experiences unplanned Defense Enrollment Eligibility Reporting System (DEERS) outages. During a DEERS outage, you may need to pay in full for prescriptions filled at retail network pharmacies and file a claim for reimbursement.
    • If you have enough medication to continue taking your medication as prescribed by your doctor, you may wish to defer the pick-up of routine prescriptions until after the DEERS outage. Once the outage ends, retail network pharmacies will resume processing TRICARE pharmacy claims as usual.

Watch this video to learn more!

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