TRICARE Preventive Care Coverage & Costs (2026 Guide) | TRICARE.com

TRICARE.com is an independent reference site and is not affiliated with the official TRICARE program or the Department of Defense. For official policy and the most current data, visit TRICARE.mil.

## Quick answer TRICARE covers most preventive care services—including annual physicals, immunizations, and cancer screenings—with **$0 out-of-pocket costs** for all beneficiaries, provided you see an in-network provider. Unlike many other medical services, you do not need to meet your annual deductible before TRICARE begins paying for preventive care.

Details

### Standard Preventive Services TRICARE focuses on early detection and disease prevention. The following services typically have a $0 copay (2026 rates) when performed by a network provider: * **Annual Wellness Exams:** One "Health Promotion and Disease Prevention" exam per year for beneficiaries age 6 and older. * **Well-Child Care:** Comprehensive exams, immunizations, and screenings for children from birth through age 5. * **Immunizations:** All CDC-recommended vaccines (e.g., flu shots, HPV, Tdap). * **Cancer Screenings:** Mammograms (starting at age 40 or earlier if high-risk), Colonoscopies (starting at age 45), and Pap tests. * **Cardiovascular Screenings:** Blood pressure checks and cholesterol testing.

### Regional Management Coverage is administered based on your location: * **TRICARE East:** Managed by Humana Military. * **TRICARE West:** Managed by TriWest Healthcare Alliance (as of January 1, 2025). * **Overseas:** Managed by International SOS.

### Plan Differences and Requirements While the benefit is largely universal, the "how" depends on your plan: * **TRICARE Prime:** You should coordinate preventive care through your Primary Care Manager (PCM). No referral is required for most standard preventive screenings, but using a network provider is mandatory to maintain the $0 cost-share. * **TRICARE Select:** You can see any network-authorized provider without a referral. If you choose to see a non-network provider, you may be subject to a deductible and cost-shares (e.g., 20% for Group A retirees). * **Point-of-Service (POS) Charges:** If you are on Prime and see a non-network provider for a preventive service without an authorization, you may be hit with POS charges, which include a $300 deductible and 50% cost-shares.

### Recent Coverage Updates As of 2026, TRICARE continues to align with the Affordable Care Act (ACA) guidelines for preventive "Value-Based" care, even though TRICARE is governed by different statutes (Title 10). This includes expanded access to specialized screenings for those with high-risk genetic factors for breast or ovarian cancer.

## Who this affects * **Active Duty Service Members (ADSMs):** Required to stay current on preventive care for medical readiness; $0 cost. * **Active Duty Family Members (ADFMs):** $0 cost at network providers across Prime and Select. * **Retirees and their Families:** $0 cost for clinical preventive services at network providers. * **National Guard and Reserve:** Beneficiaries using TRICARE Reserve Select (TRS). * **Young Adults:** Beneficiaries enrolled in TRICARE Young Adult (TYA).

## Sources * **TRICARE.mil:** [Preventive Care Services](https://www.tricare.mil/CoveredServices/IsItCovered/PreventiveCare) * **Humana Military (East):** [Preventive Care Overview](https://www.humanamilitary.com/beneficiary/health-and-wellness/preventive-care) * **TriWest Healthcare Alliance (West):** [Provider & Beneficiary Services](https://www.triwest.com) * **CDC:** [Advisory Committee on Immunization Practices (ACIP)](https://www.cdc.gov/vaccines/acip/index.html)