TRICARE prepares to expand preventive service coverage

| October 21, 2016 | 0 Comments

New options designed to promote wellness

News Release
TRICARE has always had excellent coverage of important preventive services, and we are making it better.

TRICARE is adding new services and screenings to ensure our preventive services are aligned with recommendations of the United States Preventive Services Task Force (USPSTF), and the Health Resources and Services Administration’s (HRSA) guidelines.

Coming in 2017
Effective Jan.1, 2017, TRICARE will cover annual preventive office visits for all Prime beneficiaries 6 years of age and older. Children under 6 are already covered by existing well-child coverage.

This change will ensure children in developing stages receive observation, physical examination, screening, immunizations and various counseling services.

TRICARE Standard beneficiaries can receive preventive services with no cost-share or copayment through Health Promotion and Disease Prevention (HP&DP) examinations (i.e., in connection with a covered immunization or cancer screening).

Additionally, the annual well-woman exam will continue to be covered for all Prime and Standard beneficiaries under age 65 with no cost-share or copayment. The new covered services include free genetic counseling by a TRICARE-authorized provider.

An authorized provider is any individual, institution/organization or supplier that is licensed by a state, accredited by a national organization or meets other standards of the medical community, and is certified to provide benefits under TRICARE.

There are two types of TRICARE-authorized providers: network and non-network. The regional contractors will be ready to process claims for the new preventive benefits on Nov. 14, the implementation date of this change. The implementation date is the date the contractor must be ready to communicate and process claims for this benefit.

You can find information on both medical claims and covered services on the TRICARE website at

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Category: Community, Health

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