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...

Changes in TRICARE Plan Enrollment (July 2019)

Report
1/9/2020

To assess the impact of plan changing in TRICARE, we examined data from the first quarter of the 2019 Health Care Survey of Department of Defense Beneficiaries (HCSDB), which was fielded during open enrollment.

Recommended Content:

Health Care Survey of DoD Beneficiaries | TRICARE Health Program

Achievements in 2019 provide strong foundation for year ahead

Article
12/23/2019
A Year in Review: Year of Military Health 2019

Dedication, commitment to mission praised as changes continue

Recommended Content:

TRICARE Health Program | MHS GENESIS | Research and Innovation | Preventive Health | MHS Transformation

3D Mammography Toolkit

Publication
12/19/2019

Recommended Content:

3-D Mammography | TRICARE Health Program | Women's Health

New 3-D mammogram option the next step in diagnosis, treatment

Article
12/19/2019
Chief Hospital Corpsman Naomi Perez, a certified mammogram technician (left), conducts a mammogram for a patient at Naval Hospital Pensacola. A mammogram is a low-dose X-ray procedure used to detect the early stages of breast cancer. A policy change effective Jan. 1, 2020, will allow digital breast tomosynthesis, or 3-D mammography, to be used to screen for breast cancer. The procedure – known technically as Digital Breast Tomosynthesis (DBT) – will be offered primarily to women age 40 and older, and women age 30 and older who are considered high-risk for breast cancer.  The procedure’s 3-D images provide a more thorough means of detecting the disease. (U.S. Navy Photo by Mass Communication Specialist 1st Class Brannon Deugan)

Procedure would enhance effectiveness of breast cancer screening

Recommended Content:

TRICARE Health Program | Women's Health

3D Mammogram Screensaver

Photo
12/17/2019
This graphic states information about 3-D Mammography

Share this screensaver to spread the word about 3-D Mammography coverage

Recommended Content:

3-D Mammography | Access to Health Care | TRICARE Health Program

3D Mammogram Facebook Post

Photo
12/17/2019
This graphic states information about 3-D Mammography

Share this graphic to spread the word about 3-D Mammography coverage

Recommended Content:

3-D Mammography | TRICARE Health Program

3D Mammography Infographic 1

Publication
12/16/2019

Share this infographic to spread the word about 3-D Mammography coverage

Recommended Content:

TRICARE Health Program | Women's Health | 3-D Mammography

Talking_Points_3D_Mammography

Publication
12/16/2019

These talking points share information about 3-D mammography

Recommended Content:

TRICARE Health Program | Women's Health | 3-D Mammography

3D Mammography Infographic 2

Publication
12/16/2019

Share this infographic to spread the word about 3-D Mammography coverage

Recommended Content:

TRICARE Health Program | Women's Health | 3-D Mammography

TRICARE Specialty Drug Network Accessibility

Congressional Testimony
12/13/2019

H.R. 2500, HASC Report for FY 2020, 116-120, Pg. 167

Recommended Content:

TRICARE Health Program

Open Season and BWE Issue Annex

Publication
11/23/2019

This Open Season and BWE Issue Annex contains products with additional information about how to enroll during Open Season

Recommended Content:

Open Season 2019 | TRICARE Health Program

Annex TRICARE Open Season 2019 Infographic 11x17 Flattened

Publication
11/22/2019

Share this to spread information about Open Season enrollment!

Recommended Content:

TRICARE Health Program | Open Season 2019

BWE Issues How to Enroll During Open Season

Publication
11/22/2019

Share this to spread information about BWE experiencing a technical issue

Recommended Content:

TRICARE Health Program | Open Season 2019

BWE Issues How to Enroll During Open Season with FEDVIP

Publication
11/22/2019

Share this to spread information about BWE experiencing a technical issue

Recommended Content:

TRICARE Health Program | Open Season 2019

Annex TRICARE Open Season 2019 Infographic 8x11 Flattened

Publication
11/22/2019

Share this to spread information about Open Season enrollment!

Recommended Content:

TRICARE Health Program | Open Season 2019
<< < 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.