Take Command: Improvements in Preventive Care Coverage with TRICARE Select
On Jan. 1, 2018, TRICARE Select will replace TRICARE Standard and TRICARE Extra. As a result, beneficiaries will notice improved coverage for preventive services with TRICARE Select. Preventive care helps you take command of your health and manage potential issues before you experience symptoms. This type of health care allows you to address health problems before they become life threatening. Examples of TRICARE-covered preventive services include cancer screenings and vaccines, in addition to well-woman and well-child exams.
If you currently use TRICARE Standard and TRICARE Extra, you don’t pay anything for certain preventive services. But for all other preventive services, beneficiaries pay between 15–25 percent of the cost after their yearly deductible is met, depending on the plan and beneficiary category.
“With TRICARE Select, beneficiaries won’t pay anything out-of-pocket for covered preventive services if they are provided by a network provider,” said Valerie Palmer, a health care policy analyst for TRICARE. “However, if they use a non-network provider, fewer preventive services are paid by TRICARE. This is why it is important to see a network provider for your preventive care.”
The additional, no-cost preventive services beneficiaries can receive under TRICARE Prime that TRICARE Select will cover beginning in 2018 include:
- One Health Promotion and Disease Prevention (HP&DP) exam: This is covered annually for beneficiaries age 6 and older. In 2018, this exam will no longer require the inclusion of a covered cancer screening or immunization if you see a network provider.
- Lung cancer screening (low-dose computed tomography): This is covered annually for persons ages 55-80 with a 30 pack-per-year history of smoking who are currently smoking or have quit within the past 15 years. Screening should be discontinued once the individual has not smoked for 15 years or develops a health problem significantly limiting life expectancy or ability or willingness to undergo curative lung surgery.
- Abdominal Aortic Aneurysm (AAA): This is a one-time screening using ultrasonography for men ages 65-75 who have ever smoked.
A new preventive service added this year for both TRICARE Prime and TRICARE Select is aimed at adults with a Body Mass Index (BMI) of 30 kg/m2 or higher and children or adolescents with a BMI value greater than the 95th percentile. Intensive, multi-component behavioral interventions to promote sustained weight loss (12 to 26 sessions per year) are covered when rendered by a TRICARE-authorized provider. Types of behavioral management interventions include diet and physical activity guidance, strategies to promote and maintain lifestyle changes and more. This addition is a covered benefit regardless of whether the beneficiary uses a network or non-network provider, though costs are typically lower with a network provider.