Age-appropriate immunizations and vaccines are covered in accordance with Centers For Disease Control and Prevention (CDC) age and frequency recommendations. For new CDC recommendations made after the annual schedule has been published, coverage for the immunization is effective the date the recommendation is published in the Morbidity and Mortality Weekly Report (MMWR). Immunizations and vaccines administered at a participating retail network pharmacy are covered by TRICARE when available. Visit TRICARE's Vaccine Program page to learn more. Immunizations and vaccines solely required for job placement or vocational school are not a covered benefit.
Immunizations are covered for active duty family members who accompany the active duty service member overseas during a permanent change of station. Immunizations are not covered for non-service connected travel.
Not a covered benefit. See infertility treatment for additional information.
TRICARE covers screening for individuals who have been exposed or are at high risk for several infectious diseases, including hepatitis B and HIV. Pregnant women may be screened for hepatitis B, HIV and rubella antibodies. Beneficiaries at risk for active disease are eligible for screening and/or prophylaxis for tetanus, rabies, hepatitis A and B, meningococcal meningitis, and tuberculosis. See also Immunizations.
Infertility treatment is a limited benefit. More >>
Injection/infusion medication is a limited benefit. More >>
Not a covered benefit.
Certain procedures are only payable by TRICARE when performed in an inpatient setting. TRICARE designates these as inpatient-only services, and they are not covered when performed in an outpatient or ambulatory setting. Associated services such as facility, anesthesiologist and other procedures performed also are not covered.
The Defense Health Agency provides an inpatient-only code list that specifies which services are only paid when performed in an inpatient setting. Visit www.tricare.mil/inpatientprocedures/.
Intelligence testing is a limited benefit and only covered when medically necessary for the diagnosis or treatment planning of covered psychiatric disorders. Cost Information
Intelligence testing is not covered when used:
An intensive outpatient program (IOP) for behavioral health or chemical dependency is not a covered benefit. Half-day partial hospitalization programs (PHP) may be considered as an alternative.