Your Contacts

DHA Appeals

Defense Health Agency
Appeals, Hearings and Claims Collection Division
16401 E. Centretech Parkway
Aurora, CO 80011-9066


TRICARE East Region Appeals

TRICARE East RegionAlabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding El Paso area), Vermont, Virginia, West Virginia, and Wisconsin.

PO Box 8923

Madison, WI 53707-8923

Fax: (608) 221-7536  


TRICARE West Region Appeals

TRICARE West RegionAlaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington and Wyoming.
Appeals Department
P.O. Box 8008
Virginia Beach, VA 23450-8008

Fax: 1-844-802-2527


Overseas Appeals

International SOS Assistance, Inc.
Reconsideration/Grievances Department
P.O. Box 11570
Philadelphia, PA 19116 USA

Overseas Appeals


TRICARE For Life Appeals

WPS-TRICARE For Life
Attn: Appeals
P.O. Box 7490
Madison, WI 53707-7490


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Medical Necessity Appeals

You can file a medical necessity appealThe action you take if you don’t agree with a decision made about your benefit. if we deny pre-authorization for care or services because we feel it isn’t medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition.

Medical necessity appeals can be either expedited or non-expedited.

  • Most are non-expedited.
  • Expedited appeals are only to reconsider the continuation of inpatient stays or pre-authorization of services.
  • The denial decision explains how to file an expedited appeal.
  • Keep copies of everything for your records.

To File a Medical Necessity Appeal:

  • Send a letter to your contractor's address. Make sure the postmark is within 90 days of the date on the explanation of benefits (EOB) or other decision.
  • Include a copy of the EOB or other decision.
  • Include any supporting documents.
  • If you don’t have all the supporting documents, send the appeal with what you have. Make sure to state that you’ll send more information soon.

The contractor sends you an appeal decision. If you disagree with the decision, you can request a reconsideration from the TRICARE Quality Monitoring Contractor.

To Request a Reconsideration Decision:

Send a letter to the TRICARE Quality Monitoring Contractor. Make sure the postmark is within 90 days of the date on the appeal decision.

  • You can find the address in the appeal decision letter from your contractor.
  • Include a copy of the appeal decision.
  • Include any supporting documents.

The TRICARE Quality Monitoring Contractor reviews the case and issues a reconsideration decision.

  • If the disputed amount is less than $300, the decision is final.
  • If the disputed amount is $300 or more, you can request an independent hearing.

To Request an Independent Hearing:

  • Send a hearing request to the Defense Health Agency. Make sure the postmark is within 60 days of the date of the formal review decision.
  • Include a copy of the formal review decision.
  • Include any supporting documents you haven’t submitted before.

The independent hearing takes place at location convenient to both the requesting party and the government.

  • An independent hearing officer issues a recommended decision.
  • The final decision is issued by the Defense Health Agency director (or designee) or the Assistant Secretary of Defense for Health Affairs.  

Last Updated 5/3/2023