TRICARE Preventive Care: Coverage and 2026 Costs | TRICARE.com

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## Definition Preventive care includes medical services like checkups, vaccinations, and screenings designed to prevent illnesses or detect problems early when they are easiest to treat.

## What it means in practice For most TRICARE beneficiaries, preventive care is the most affordable part of their health plan. Under TRICARE Prime and TRICARE Select, nearly all clinical preventive services are provided with **$0 out-of-pocket costs**, provided you see an in-network provider. This applies even if you haven't met your annual deductible. TRICARE prioritizes these services because keeping the force and their families healthy reduces long-term costs for the Defense Health Agency.

In practice, this means your annual "wellness" exam, routine immunizations (such as the flu shot or HPV vaccine), and cancer screenings (like mammograms, colonoscopies, and pap smears) are covered 100%. While most health plans require a copay for a "sick visit," a preventive visit is typically free. However, if you discuss a new medical issue or receive a diagnosis during a preventive exam, the provider may bill that portion of the visit as a diagnostic office visit, which could trigger a 2026 copayment depending on your plan group.

TRICARE follows the recommendations of the U.S. Preventive Services Task Force (USPSTF) and the CDC. Covered services currently include: * **Well-child care:** Routine exams from birth through age 5. * **Adult Physicals:** One annual exam for Prime members; Select members may have coverage limitations based on age or risk factors. * **Screenings:** Blood pressure, cholesterol, diabetes, and certain genetic screenings for high-risk individuals. * **Mental Health:** Annual depression screenings and alcohol misuse screenings.

If you are using **TRICARE For Life**, TRICARE acts as the second payer to Medicare. As long as the preventive service is covered by both Medicare and TRICARE, you will typically pay $0. In the West Region, these services are coordinated through TriWest Healthcare Alliance, while Humana Military manages them in the East Region.

## Related terms * **Catastrophic Cap:** The maximum out-of-pocket amount a beneficiary pays each calendar year for covered medical services. * **Network Provider:** A healthcare professional or facility that has a contract with TRICARE (via TriWest or Humana Military) to provide care at negotiated rates. * **Cost-Share:** The percentage of the total cost of a covered healthcare service that the beneficiary pays after the deductible is met. * **Primary Care Manager (PCM):** The specific provider or clinic assigned to a Prime member to coordinate all care, including preventive screenings. * **Evidence-Based Medicine:** Medical practices and screenings that have been proven effective through scientific study, which TRICARE uses to determine coverage.

## Sources * TRICARE.mil: Preventive Services (https://www.tricare.mil/HealthWellness/Preventive) * Defense Health Agency: TRICARE Health Plan (https://health.mil) * TriWest Healthcare Alliance: West Region Portal (https://www.triwest.com)