How to appeal a TRICARE denial
The short answer
TRICARE gives you 90 days after the date on the notice to mail a request for reconsideration. After that come a formal review and, when $300 or more is in dispute, a hearing.
Deadlines, decision times and your rights
These are the limits in the federal rules. Your plan can give you more time but not less. If your denial letter prints an earlier date, go by the earlier one.
Deadline to appeal
Mail within 90 days after the date of the denial notice
Rule: 32 CFR 199.10(b)(1)(iii)
What the rule says
The request must be mailed within 90 days after the date of the notice of initial determination.
How long they have to decide
Normally within 60 days after the contractor receives your request
Rule: 32 CFR 199.10(b)(3)
What the rule says
OCHAMPUSEUR, the CHAMPUS contractor, or CHAMPUS peer review organization normally shall issue its reconsideration determination no later than 60 days from the date of receipt of the request for reconsideration by OCHAMPUSEUR, the CHAMPUS contractor, or the CHAMPUS peer review organization.
The next level
Mail within 60 days after the date of the reconsideration decision
Rule: 32 CFR 199.10(c)(1)(iii)
What the rule says
The request shall be mailed within 60 days after the date of the notice of the reconsideration determination or OCHAMPUS initial determination being appealed.
Mail within 60 days after the date of the formal review decision
Rule: 32 CFR 199.10(d)(1)(iii)
What the rule says
The request shall be mailed within 60 days after the date of the notice of the initial determination or formal review determination being appealed.
Each rule links to its text in the Electronic Code of Federal Regulations. Checked against the regulation text on November 10, 2026. The Lamdis app works out your dates from these same rules.
The levels
- Reconsideration. Mail your request within 90 days after the date on the notice of the decision (32 CFR 199.10(b)(1)(iii)). The reconsideration is normally decided within 60 days of receipt (32 CFR 199.10(b)(3)).
- Formal review. Mail the request within 60 days after the date on the reconsideration decision (32 CFR 199.10(c)(1)(iii)). If less than $50 is in dispute, the reconsideration is final.
- Hearing, when $300 or more is in dispute (32 CFR 199.10(c)(4)(v)).
The regulation still uses older names such as OCHAMPUS and CHAMPUS for TRICARE’s offices.
Where to send it
Send your appeal to the address on the decision notice. Your regional contractor handles most first-level appeals, and the TRICARE file-an-appeal page lists where each kind goes.
Mailing date matters
TRICARE counts a reconsideration request as filed on the date it is mailed and postmarked. Keep proof of the mailing date.
Questions people ask
How long do I have to appeal a TRICARE denial?
Mail your request within 90 days after the date on the notice (32 CFR 199.10(b)(1)(iii)).
I have TRICARE For Life. Which process do I use?
TRICARE For Life pays after Medicare. If Medicare denied the service, start with the Medicare appeal on the Original Medicare page.
Sources
- eCFR: 32 CFR 199.10, Appeal and hearing procedures
The request must be mailed within 90 days after the date of the notice of initial determination.
- TRICARE: File an Appeal
This page is general information about appeal rules in the United States. It is not legal or medical advice. Rules can change, and your plan’s documents and your denial letter control the dates that apply to you.