Although your health benefits offer high-quality coverage, TRICARE leaves you responsible for some out-of-pocket costs – costs that can really add up if you or a loved one suffer from a serious or chronic medical condition.
Yes! I want to help protect myself or my loved ones from uncovered medical costs!Enroll Now
The Supplement Plan pays eligible out-of-pocket expenses, after any applicable deductible, as follows:
Present your Identification Card to your medical provider’s billing department for submission of your claim.
Submit your Explanation of Benefits and itemized bill or receipt to:
P.O. Box 1868
Grapevine TX 76099
or by fax: (469) 417-1960
A claim form is not required.
To check your claim status call
You may also create an account at:
All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company and Hartford Life Insurance Company detail exclusions, limitations, and terms under which lhe policies may be continued in force or discontinued.
The Hartford ® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing companies Hartford Life and Accident Insurance Company and Hartford Life Insurance Company, Hartford, CT 06155.
TRICARE Form Series includes SRP-1269, or state equivalent.
TRICARE Supplement may not be available in all states.
© Military Benefit Association