DD2642 PDF

However, under certain circumstances you can submit your claims to us. For the best experience on this website, please disable all pop-up blockers and use one of the following Web browsers: Internet Explorer, Safari, or Chrome. All rights reserved. Submitting Claims. Durable medical equipment DME and supplies from network or non-network providers. Your provider must submit claims on your behalf for: Services performed by a network provider except DME.

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Sometimes, you'll need to file your own claims i. You'll need to use this form when you submit claims for an injury or illness caused by a third party:. Medicare claims must be submitted within one year of service. Health Plans. Compare Plans. Enroll or Purchase a Plan. Using Other Health Insurance.

Dental Plans. Special Programs. Find a Doctor. Provider Types. All Provider Directories. Find a Military Hospital or Clinic.

Book Appointments. Getting Care When on Active Duty. Getting Care When Traveling. What's Covered. Health Care. Dental Care. Mental Health Care. Special Needs. Vision Care. Benefit Updates. How a Benefit Becomes Covered. Health Plan Costs.

Cost Terms. Dental Costs. Pay My Bill. Life Events. Qualifying Life Events. Separating from Active Duty. Giving Birth or Adopting. Getting Married. Getting Divorced. Becoming Medicare-Eligible. Going to College. Children Becoming Adults.

Losing or Gaining Other Health Insurance. Death in the Family. Moving When Deploying. Injured on Active Duty. Filing Claims. Download a Form. Briefing Request Form. Medical Claims. Claims Filing Addresses. Prescription Claims. Dental Claims. Continued Health Care Benefit Program. Defense Health Agency-Great Lakes. Dental Programs. Fees and Payments. Other Health Insurance.

Pharmacy Program. Prime Travel Benefit. Contact Us. Call Us. Find My Login. Find a Claims Address. Ask a Benefit Question. File a Complaint. Report Fraud and Abuse. Health and Wellness. Healthy Living. Alcohol Awareness. Tobacco Cessation. Preventive Services. Disaster Information. Go Paperless. My Military Health Records. Multimedia Center. Recoupment of Overpayments. Rights and Responsibilities. About Us. News Center. Facts and Figures. For Providers. For Staff. For Members of the Media.

For Vendors. Send the claim form and supporting documents: To the appropriate claims address Within the specified deadlines: U. Due to security settings, you may have to right-click and select "Save As" to download certain DD Forms.

8NP 316 PDF

Medical Claims

Sometimes, you'll need to file your own claims i. You'll need to use this form when you submit claims for an injury or illness caused by a third party:. Medicare claims must be submitted within one year of service. Health Plans.

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