MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. – Under the Families First Coronavirus Response Act, TRICARE is waiving copays for office visits in which the provider tested the beneficiary for COVID-19. Copays will be waived retroactively to March 18 for approved COVID-19 diagnostic testing and office visits related to the testing. If you paid any copays for testing related to COVID-19 and the resulting office visits with a network or non-network provider, you may file a TRICARE Claim Form (DD2642) to receive reimbursement. It’s important to note that this only applies to active duty family members, retirees and retiree family members who do not require a pre-authorization for an urgent care center (UCC) visit in the network. This does not apply to active duty service members who should not be using a UCC without a pre-authorization.
Visit https://tricare.mil/FormsClaims/Claims/MedicalClaims for more information and to download TRICARE Claim Form (DD2642)
Steps for filing a TRICARE Claim Form (DD2642) for reimbursement:
1. Fill out the TRICARE Claim Form: Download the Patient's Request for Medical Payment (DD Form 2642).
2. Fill out all 12 blocks of the form completely.
3. Sign the form.
4. Include a Copy of the Provider's Bill: 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) or Department of Defense Benefits Number (DBN) (eligible former spouses should use their SSN)
- 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)
5. Submit the Claim:
TRICARE West Region
P.O. Box 202112
Florence, SC 29502-2112
Due to the claims billing process and modifications, TRICARE can't immediately waive all copayments and cost-shares. Beneficiaries may have to pay up front and file a TRICARE Claim Form (DD2642), as outlined above, for reimbursement until the contractors can modify their systems. To qualify for this waiver, the visit detailed in the TRICARE Claim Form (DD2642) must have resulted in a provider-ordered COVID-19 test. This reimbursement also does not apply to beneficiaries with Other Health Insurance (OHI) or Medicare. U.S. law requires that all OHI, including Medicare, process health insurance claims before TRICARE.
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