TRICARE Overseas Pharmacy Claims: Prescriptions Abroad

Prescriptions are a common reason to file an overseas claim, and they have their own rules. Here is what TRICARE says.

Do you need to file a claim at all?

It depends on where the prescription was filled. TRICARE says you do not need to file a claim if the prescription was filled:

• at a military pharmacy,
• through TRICARE Pharmacy Home Delivery, or
• at a TRICARE retail network pharmacy.

If it was filled at a non-network pharmacy, you need to file a claim to be reimbursed for covered prescription drugs. TRICARE adds that in the Philippines you must get your prescription filled at a TRICARE-certified pharmacy to make sure your claims are reimbursed.

Where the claim goes

For prescriptions filled outside the United States and U.S. territories, TRICARE says to submit the claim to the TRICARE Overseas Program claims processor, either online through the secure claims portal or by mail. (For non-network pharmacies in the U.S. and its territories, a different pharmacy contractor handles claims.) Our portal guide covers the online route.

What the pharmacy receipt must show

The DD Form 2642 says prescription claims require:

• the patient’s name,
• for each drug: its name, strength, date filled, days supply, quantity dispensed and price,
• the National Drug Code (NDC) for each drug, if available,
• the prescription number of each drug,
• the pharmacy’s name and address, and
• the prescribing physician’s name and address.

The form says billing statements showing only total charges, canceled checks, and cash register or similar receipts are not acceptable unless the receipt provides all of that detail. If your pharmacy gives you a short till receipt, ask for a detailed printout or invoice.

Proof of payment

TRICARE says to submit proof of payment with overseas pharmacy claims. TRICARE’s list includes an invoice for pharmaceuticals dispensed on an outpatient basis, with a list of the prescribed drugs. See what counts as proof of payment.

On the claim form

On the DD Form 2642, check pharmacy in block 8b. In block 8a, include the health reason for the prescription, for example a condition such as diabetes. The form’s own instructions ask for this. Our block-by-block guide shows where each one goes.

How PaidTrail helps

PaidTrail reads a pharmacy bill like any other bill and shows you what it found next to the words it came from, so you can check the pharmacy, drug and price against the list above before you file.