Back to Top Skip to main content

Understanding your TRICARE explanation of benefits

Take Command of Your Health Take Command of Your Health

Recommended Content:

TRICARE Health Program

If you’ve ever visited the doctor or hospital and used your health benefits, you’ve probably received an explanation of benefits (EOB). An EOB is sent after the claim for your visit is processed. It’s an itemized statement that breaks down the cost-shares and deductibles. While an EOB isn’t a bill, it’s still an important document to read through and understand.

Medical

Your EOB will include the date you received the medical treatment or service, along with several amounts. This includes the amount billed, the amount covered, and the amount paid by TRICARE, Medicare, or other health insurance. It will show any balance you owe your provider. It will also let you know how much has been credited toward your annual deductible and catastrophic cap.

Each time you receive an EOB, compare it to the receipt or statement from the health care provider. Contact your primary insurance claims processor if you see charges for services you didn’t get. And keep your EOB statements with your health insurance records for reference. After reviewing your EOB, you can:

  • Appeal certain decisions about your claims.
  • File an appeal within 90 days of the date of the EOB notice.

TRICARE regional and overseas contractors don’t mail EOBs to you. EOB statements are available online on your TRICARE regional or overseas contractor website. You must first log in or register on their secure portal to get access to your EOB statements online. After you log in, you can then view and print your TRICARE EOB. This gives you access to your information anytime. To get to your regional or overseas contractor website, select a link below:

TRICARE contractors don’t issue an EOB to you when claims involve services related to certain sensitive diagnoses. To learn more about this, contact your TRICARE regional or overseas contractor.

Pharmacy

Your pharmacy EOB statement is a summary of your prescription claims history when you use your TRICARE pharmacy benefit. Express Scripts, the TRICARE Pharmacy Program contractor, will send you an EOB only if there’s claim activity from a retail pharmacy or TRICARE Pharmacy Home Delivery. If you only fill your prescription at a military pharmacy, you won’t receive an EOB.

Pharmacy EOB statements are printed and mailed quarterly. However, if you sign up to receive your EOB online, you’ll get a monthly notification when it’s ready. You’ll also be able to view your statements online anytime. To register online, follow the instructions on the Express Scripts website.

Dental

If you’re enrolled in the TRICARE Dental Program (TDP), you’ll receive a Dental Explanation of Benefits (DEOB) from United Concordia Companies, Inc. that explains what was covered for your dental services. The DEOB breaks down the costs for the procedures, and helps you understand how much you have to pay in cost-shares, if any. You can view your DEOB on the TDP website. Find more about a DEOB in the TRICARE Dental Program Handbook.

Remember, an EOB and a DEOB are not bills. These statements simply show you what action TRICARE has taken on your claims. For more information related to an explanation of benefits, visit the Filing Claims section. To learn more about your health care costs, visit Costs on the TRICARE website.

You also may be interested in...

DHA increases access to telehealth during COVID-19 pandemic

Article
5/19/2020
Medical personnel sitting at desk talking into laptop monitor

Use of telehealth role increases to prevent COVID-19 spread

Recommended Content:

TRICARE Health Program | Coronavirus

TRICARE Improper Medical Claims Payments

Congressional Testimony
4/24/2020

S. 1790, SASC Report for FY 2020, 116-48, Pg. 213-214

Recommended Content:

TRICARE Health Program

Benefits Eligibility for 32 USC 502(f) Missions

Publication
4/14/2020

A chart outlining the various Benefits Eligibility for 32 USC 502(f) Missions

Recommended Content:

Coronavirus | TRICARE Health Program

TRICARE Coverage of Continuous Glucose Monitors

Congressional Testimony
4/9/2020

S. 1790, SASC Report for FY 2020, 116-48, Pg. 213

Recommended Content:

TRICARE Health Program

Decision Memorandum on TRICARE Implementation of the "Families First Coronavirus Response Act"

Publication
4/7/2020

The Families First Coronavirus Response Act, Public Law 116-127, Division F, Section 6006(a), limits TRICARE authority to impose copayment or other cost-sharing for novel coronavirus (COVID-19) testing and related provider visits that result in orders for or administration of Food and Drug Administration (FDA) approved, cleared, or authorized diagnostic products. In order for the Defense Health Agency (DHA) to implement, the Assistant Secretary of Defense for Health Affairs (ASD(HA)) must acknowledge the self-executing authority of the statute and direct the Director, DHA, or designee, to issue guidance implementing the statutory provisions.

Recommended Content:

TRICARE Health Program | Coronavirus

Possible changes at MTF pharmacies in response to COVID-19

Article
3/31/2020
A military pharmacist choosing medication from a shelf

Find out the latest pharmacy policies at MTFs

Recommended Content:

Coronavirus | Public Health | TRICARE Health Program

Tiered Telehealth Health Care Support for COVID-19

Publication
3/31/2020

This memorandum establishes guidance for the use of Telehealth (TH) Information Technology (IT) tools in support of the clinical care required for patients across the spectrum of COVID-19 illness

Recommended Content:

TRICARE Health Program | Public Health | Coronavirus

Pharmacy Guidance for Market MTFs

Publication
3/31/2020

Message to Pharmacy Beneficiaries regarding military pharmacy services during the COVID-19 pandemic.

Recommended Content:

Coronavirus | Pharmacy Division | TRICARE Health Program

Q & A: Policy Exception for Telehealth Use for ABA during COVID-19 Pandemic

Publication
3/30/2020

Question and Answer: TRICARE Autism Care Demonstration (ACD): Regarding Temporary Authorization to Utilize Telehealth for CPT Code 97156 during the COVID-19 National Emergency

Recommended Content:

Coronavirus | Autism Care Demonstration | TRICARE Health Program

Policy Exception for Telehealth Use for ABA during COVID-19 Pandemic

Publication
3/30/2020

Communication to ABA Providers Regarding Temporary Authorization to Utilize Telehealth for CPT Code 97156 During the COVID-19 National Emergency

Recommended Content:

Coronavirus | Autism Care Demonstration | TRICARE Health Program

Report on Requirement for Certain Former Members of the Armed Forces to Enroll in Medicare Part B to be Eligible for TFL; TRICARE Access Study; and Improving Health Care Choices for Severely Injured Service Members

Congressional Testimony
3/2/2020

H.R. 5515, NDAA Conference Report for FY 2019, 115-874, Sec. 734; H.R. 5515, HASC Report for FY 2019, 115-676 ,Pg. 132; S 2987, SASC Report for FY 2019, 115-262, Pg. 223

Recommended Content:

TRICARE Health Program

MHS Minute February 2020

Video
2/25/2020
MHS Minute February 2020

Thanks for tuning in to the MHS Minute! This month, we highlight a historical moment in #MilitaryHealth history, as Defense Health Agency (DHA) established the first four health care markets in the military medical enterprise. We also take a look at the Military Health System (MHS) response to Novel Coronavirus -- learn more about what Madigan Army Medical Center is doing to combat the threat of illness by going to mamc.health.mil.

Recommended Content:

MHS Transformation | TRICARE Health Program | Coronavirus

TRICARE Comprehensive Autism Care Demonstration Program FY 2020

Congressional Testimony
2/21/2020

S. 2943, SASC Report for FY 2017, 114-255, Pg. 205

Recommended Content:

TRICARE Health Program | Autism Care Demonstration

Pilot Program on Incentive Programs to Improve Health Care Provided Under the TRICARE Program

Congressional Testimony
2/18/2020

S. 1356, NDAA Conference Report for FY 2016, Joint Explanatory Statement Sec. 726

Recommended Content:

TRICARE Health Program

TRICARE Prime and TRICARE Select Out-of-Pocket Expenses for Calendar Year 2020

Policy

Memo outlining the TRICARE Prime and TRICARE Select beneficiary out-of-pocket expenses for calendar year 2020. These rates will be effective January l, 2020.

<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 17

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.