Does TRICARE cover clinical trials?
Quick Answer
TRICARE covers routine patient care costs in qualifying clinical trials, including doctor visits, lab tests, and hospitalizations. The experimental treatment itself is not covered by TRICARE.
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Detailed Answer
TRICARE provides coverage for routine patient care costs associated with participation in qualifying clinical trials. This includes standard medical services that would be provided regardless of trial participation, such as doctor visits, laboratory tests, imaging, hospitalization, and management of side effects. The experimental treatment, investigational drug, device, or service being studied in the clinical trial is not covered by TRICARE and is typically provided by the trial sponsor at no cost to participants. To qualify for TRICARE coverage, the clinical trial must be sponsored or approved by a federal agency (such as the National Institutes of Health, FDA, or Department of Defense), conducted at an approved institution, and relevant to the beneficiary's medical condition. Pre-authorization from TRICARE may be required for participation in certain trials. Beneficiaries interested in clinical trials should discuss options with their provider and contact TRICARE to verify coverage of routine costs before enrolling.
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Related Questions
How much does TRICARE cost?
Costs vary by plan and beneficiary status. Active duty members have no costs. Retirees and their families pay enrollment fees and cost-shares.
What services does TRICARE cover?
TRICARE covers preventive care, doctor visits, hospitalization, surgery, mental health, maternity, prescriptions, and more with some requiring authorization.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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