TRICARE Well-Child Visit Coverage and Costs (2026) | TRICARE.com

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## Quick answer TRICARE covers well-child care from birth through age 5 at no cost to the beneficiary, provided you use an in-network provider. These visits include physical exams, immunizations, and developmental screenings designed to monitor your child's growth and health milestones.

Details

### Coverage Ages and Schedule TRICARE provides comprehensive coverage for well-child visits based on the schedule recommended by the American Academy of Pediatrics. Coverage is standard across two main age brackets:

* **Birth to Age 2:** Includes a newborn exam (often in the hospital) and approximately seven additional visits (typically at 2 weeks, and 2, 4, 6, 9, 12, 15, 18, and 24 months). * **Ages 2 to 5:** Includes annual "well-child" physicals.

### What is included in the visit? Under the current T-5 contract (effective 2025/2026), well-child care includes: * Physical examinations and measurements (height, weight, head circumference). * Vision and hearing screenings. * Immunizations as recommended by the CDC (e.g., MMR, Polio, DTaP). * Developmental and behavioral assessments (including autism screenings). * Lead toxicity screening and tuberculosis skin testing (based on risk).

### Costs and Plan Differences (2026 Rates) Child well-visits are categorized as "preventive services." In the 2026 plan year: * **TRICARE Prime (and Select):** There is **$0 copay** for well-child visits when using a network provider. * **TRICARE Select (Out-of-Network):** If you see a non-network provider, you may be subject to a deductible and cost-shares (e.g., 20% for Group A beneficiaries), though using network providers is highly encouraged to keep costs at zero. * **Point of Service (POS):** If you are on TRICARE Prime and see a doctor without a referral (when one is required), you may face significant POS charges. Always verify if your Prime PCM is the one performing the exam.

### School and Sports Physicals It is important to note that while "Well-Child" visits (ages 0-5) are fully covered, **School Physicals** and **Sports Physicals** for children ages 6 and older are generally *not* covered by TRICARE, unless they are required for school and are performed during a covered annual health promotion and disease prevention (HP&DP) exam.

## Who this affects * **Active Duty Families:** Spouses and children of active duty service members (ADFMs) on Prime or Select. * **Retirees and Families:** Families of retired service members. * **National Guard and Reserve:** Beneficiaries using TRICARE Reserve Select. * **Survivors:** Eligible children of deceased service members.

## Sources * **TRICARE.mil:** [Well-Child Care Overview](https://www.tricare.mil/CoveredServices/IsItCovered/WellChildCare) * **Humana Military (East):** [Preventive Care Services](https://www.humanamilitary.com/beneficiary/plans-and-programs/benefits/preventive-care) * **TriWest Healthcare Alliance (West):** [Preventive Services Guidelines](https://www.triwest.com/en/beneficiary/wellness-and-preventive-care/) * **CDC:** [Recommended Immunization Schedule](https://www.cdc.gov/vaccines/schedules/)