TRICARE Wellness & Preventive Care Guide 2026
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## Quick answer TRICARE covers a wide array of wellness and preventive services at zero out-of-pocket cost to most beneficiaries, provided they use an in-network provider. This includes annual "Health Promotion and Disease Prevention" (HP&DP) exams, immunizations, cancer screenings, and well-child care. These services do not require a referral or a copayment under most TRICARE plans.
## In detail Wellness under TRICARE is categorized primarily as **preventive care**. The goal is to identify health issues before they become chronic or life-threatening.
### Annual Wellness Exams TRICARE covers one Health Promotion and Disease Prevention (HP&DP) exam per fiscal year for beneficiaries aged 6 and older. * **TRICARE Prime:** No copayment when using your Primary Care Manager (PCM). * **TRICARE Select:** No copayment when using a network provider (2026 rates). If you use a non-network provider, you may be subject to point-of-service charges or deductibles.
### Covered Preventive Services (2026 Benefit Year) Most preventive services are covered with **$0 out-of-pocket costs** when seen by a network provider: * **Cancer Screenings:** Includes mammograms (starting at age 40, or younger for high-risk), colonoscopies (starting at age 45), Pap smears, and prostate exams. * **Immunizations:** All CDC-recommended vaccines (Flu, COVID-19, HPV, Shingles, etc.) are covered at no cost via a TRICARE provider or an Express Scripts network pharmacy. * **Cardiovascular Screening:** Cholesterol tests and blood pressure monitoring. * **Well-Child Care:** Comprehensive coverage for children from birth to age 6, including developmental screenings and hearing tests. * **Mental Health:** Annual depression and alcohol misuse screenings.
### Wellness Programs by Region While the Defense Health Agency (DHA) sets the benefits, the regional contractors provide specific wellness tools: * **East Region (Humana Military):** Offers "HumanaBeginnings" for expectant mothers and various health coaching programs for weight management and tobacco cessation. * **West Region (TriWest Healthcare Alliance):** Provides online wellness portals and disease management programs for chronic conditions like asthma or diabetes.
### Comparison of Wellness Costs (2026) | Service | TRICARE Prime (Network) | TRICARE Select (Network) | | :--- | :--- | :--- | | **Annual Wellness Exam** | $0 | $0 | | **Well-Child Visits** | $0 | $0 | | **Immunizations** | $0 | $0 | | **Screening Mammogram** | $0 | $0 | | **Smoking Cessation** | $0 | $0 |
## Who this applies to * **Active Duty Service Members (ADSMs):** Mandatory periodic health assessments (PHAs) are covered; all wellness care is $0. * **Active Duty Family Members (ADFMs):** $0 for all preventive services in-network regardless of plan (Prime or Select). * **Retirees and their Families:** $0 for preventive services in-network. Note that if a "wellness" visit turns into a "diagnostic" visit (e.g., the doctor finds a problem and treats it), a standard copay may apply for the diagnostic portion. * **TRICARE Reserve Select (TRS) / Retired Reserve (TRR):** $0 for in-network preventive care once the enrollment is active.
Common scenarios
**1. The Annual Physical** Jane is an ADFM on **TRICARE Select** in the West Region. She schedules her 2026 annual wellness exam with a TriWest network doctor. Because it is a preventive visit, Jane pays **$0**, and the deductible does not apply to this specific visit.
**2. Shingles Vaccination** Mark, a 62-year-old retiree on **TRICARE For Life**, goes to an Express Scripts network pharmacy to get the Shingrix vaccine. In 2026, TRICARE covers this at **$0 copay** because it is a CDC-recommended preventive immunization.
**3. Diagnostic Overlap** Robert (Retiree, Prime) goes in for a $0 wellness screening. During the exam, he asks the doctor to look at a new painful joint issue. The doctor performs an assessment and orders an X-ray. While the wellness exam remains **$0**, Robert may be charged his 2026 Prime retiree copayment (approx. $25–$38 depending on Group A/B status) for the diagnostic portion of the visit.
## Related terms * **HP&DP Exam:** Health Promotion and Disease Prevention exam; the official TRICARE term for a "physical." * **Primary Care Manager (PCM):** The specific doctor or clinic assigned to Prime members to coordinate all wellness care. * **Network Provider:** A civilian doctor who has a contract with Humana Military or TriWest to provide care at discounted rates. * **Point-of-Service (POS) Option:** An additional cost incurred if a Prime member sees a doctor for non-emergency care without a referral from their PCM. * **Diagnostic Care:** Healthcare services used to monitor or treat a condition after symptoms have appeared (unlike wellness care, which is preemptive).
## Sources * **TRICARE.mil Preventive Care:** https://www.tricare.mil/CoveredServices/IsItCovered/PreventiveCare * **Humana Military (East):** https://www.humanamilitary.com/beneficiary/health-and-wellness * **TriWest Healthcare Alliance (West):** https://www.triwest.com/ * **CDC Advisory Committee on Immunization Practices (ACIP):** https://www.cdc.gov/vaccines/acip/index.html