Your Profile
Patient & sponsor info — saved to your browser
🔒 Written to your PDF only — never transmitted or stored online. Privacy
This Visit
Claim type, description, and service dates
Include financial details?
Entering your billed amounts and payments is helpful when submitting into the TRICARE Claim Portal and for keeping track of claims that are being processed or have not yet been paid.
Financial Details
Itemized bills, totals, and payment information
Ready to generate your DD Form 2642, financials (optional) and claim package
Print the DD Form 2642 online to ensure it is correct, then print it and sign it. If you chose to review your financials for the TRICARE Claim Portal, you can review them online and print them to assist you in entering into the portal. Lastly, the Claim Package Generator assembles all your documents into one package to include a cover sheet.
A Claim Package is a single PDF that combines all your documents in the correct TRICARE submission order: a cover page, your signed DD 2642, itemized bills from the provider, and proof of payment. You upload your printed and signed DD 2642 along with the other documents to build this combined file — then you submit it to TRICARE.
Profile Data Backup & Restore
Browsers can be cleared, taking your data with them. We recommend creating a folder called “File My Claim” on your computer or iCloud Drive and exporting your data there immediately after completing your profile.