TRICARE Toolkit: Navigating Your Explanation of Benefits

TRICARE Toolkit: Navigating Your Explanation of Benefits
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TRICARE-Toolkit-logo-draft.jpgMOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email Read other TRICARE Toolkit columns at


TRICARE beneficiaries track their annual medical expenses by accessing their explanation of benefits (EOB). The EOB statement is not a bill; it delineates an itemized summary action TRICARE has taken on claims filed by your provider or past medication orders.


Active-duty families and retirees who only use military treatment facilities (MTFs) have probably never encountered an EOB because MTF care and pharmacy services are provided without a co-payment; no EOB is generated.


Many TRICARE network providers seek co-payments at the time the patient is seen. However, the Defense Health Agency recommends anytime you see your doctor, dentist, or pharmacist or receive care from a hospital, you should try to access your EOB before receiving the bill — or after paying your co-payment — to verify the amount charged is in line with your plan’s benefits.


[RELATED: MOAA's 2022-23 TRICARE Guide]


It is important to understand the contents of your EOB and to read through it carefully.


EOBs typically contain the following information:

  • The date you received a medical treatment or service.
  • The amount billed by the provider.
  • The amount covered by TRICARE, Medicare, or other health insurance, if applicable.
  • Any balance you owe the provider.
  • How much of the cost has been credited to your annual deductible and catastrophic cap.


You can access your medical EOB through a secure portal on the website of your specific TRICARE contractor.


What should you look for on your medical EOB?

  • Did you receive the medical services listed on the EOB?
  • Are you being billed more than once for the same service?
  • How much of your care is covered, and what are you expected to pay?
  • Was your claim accepted or denied?


[RELATED: TRICARE Will Pay for More Dialysis Services After Rise in Kidney Disease]


Your pharmacy EOB is similar to, but not exactly the same as, your medical EOB. It is a summarized statement of processed pharmacy claims. Again, no EOB is generated from medications dispensed from an MTF pharmacy.


To access pharmacy EOBs, visit If you have signed up to receive pharmacy EOBs online, you’ll get an email once each month that lets you know when an updated EOB is available.



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About the Author

Capt. Paul J. Frost, AFC®, USN (Ret)
Capt. Paul J. Frost, AFC®, USN (Ret)

Frost co-leads MOAA's Financial and Benefits Education program and is also an accredited Veteran Service Officer (VSO), providing VA disability compensation claim and appeal information and advice to the military community.