Preventive Care TRICARE: Coverage, Costs, and Rules | TRICARE.com

## Quick answer TRICARE covers a wide range of preventive care services—such as annual wellness exams, vaccinations, and cancer screenings—at **zero out-of-pocket cost** for most beneficiaries when using an in-network provider. You do not need a referral for clinical preventive services, though some specific screenings may have age or frequency requirements.

*Disclaimer: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy and enrollment, visit TRICARE.mil.*

Details

### What is Covered for Free? Under the current T-5 contract (effective 2025/2026), TRICARE prioritizes preventive health to reduce long-term costs. The following are typically covered with **$0 copays** (as of 2026 rates) when you see a network provider:

* **Annual Physicals:** One per year for all beneficiaries. * **Vaccinations:** CDC-recommended vaccines (Flu, COVID-19, HPV, Shingles, etc.). * **Cancer Screenings:** Mammograms (starting at age 40, or earlier for high-risk), Colonoscopies (starting at age 45), and Pap smears. * **Well-Child Care:** Comprehensive exams from birth through age 17. * **Well-Woman Exams:** Includes breast exams and pelvic exams. * **Cardiovascular Screenings:** Blood pressure and cholesterol checks.

### Network vs. Non-Network To ensure $0 costs, you must follow the rules of your specific plan: * **TRICARE Prime:** You must use a network provider or a Military Treatment Facility (MTF). If you use the Point-of-Service (POS) option to see a non-network provider for preventive care, you will likely owe a deductible and 50% cost-sharing. * **TRICARE Select:** Preventive services are $0 in-network. If you choose an out-of-network provider, you may be subject to a deductible and a percentage of the allowable charge (2026 rates vary by Group A vs. Group B status).

### Contractor Management Preventive care is managed by the regional contractor for your area: * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance**. * **Pharmacy/Vaccines:** While many vaccines are available at doctor offices, those administered at retail pharmacies are managed by **Express Scripts**.

### Exclusions and Limits TRICARE generally does not cover "elective" screenings that are not recommended by the U.S. Preventive Services Task Force (USPSTF). For example, genetic testing is typically only covered if you show symptoms or meet very specific high-risk criteria, rather than as a general "preventive" measure.

## Who this affects * **Active Duty Service Members (ADSMs):** Always $0; must follow military medical readiness requirements. * **Active Duty Family Members (ADFMs):** $0 for all preventive services in-network. * **Retirees and their Families:** $0 for in-network preventive care; costs apply if using out-of-network providers. * **National Guard and Reserve:** Included if enrolled in TRICARE Reserve Select (TRS). * **TRICARE For Life (TFL):** TRICARE acts as the secondary payer to Medicare; if both cover the service, the out-of-pocket cost is typically $0.

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