TRICARE Preventive Care Coverage & Costs (2026 Guide)
*Note: TRICARE.com is an independent reference site and is not the official TRICARE program or affiliated with the Department of Defense. For official policy and enrollment, visit TRICARE.mil.*
## Quick answer Yes, TRICARE covers a wide range of preventive care services with **$0 out-of-pocket costs** for most beneficiaries, provided you see an in-network provider. This includes annual physicals, immunizations, cancer screenings, and well-child visits, often without requiring a referral.
Details
### $0 Cost-Share for Preventive Services For the vast majority of TRICARE plans—including TRICARE Prime, TRICARE Select, and TRICARE For Life—preventive services are covered at 100% when you use a network provider. You typically do not have to meet your annual deductible before these services are covered.
### What is Covered? TRICARE generally follows the guidelines set by the U.S. Preventive Services Task Force (USPSTF) and the CDC. Key covered services for the 2026 plan year include:
* **Annual Health Promotion and Disease Prevention (HP&DP) Exams:** One clinical preventive exam per year for beneficiaries age 6 and older. * **Well-Child Care:** Comprehensive coverage including physical exams, sensory screenings, and developmental assessments for children from birth through age 5. * **Immunizations:** All CDC-recommended vaccines (Flu, COVID-19, HPV, Shingles, etc.) are covered at no cost at network providers or via Express Scripts at participating pharmacies. * **Cancer Screenings:** Coverage includes mammograms (starting at age 40, or earlier for high-risk), colonoscopies (starting at age 45), Pap smears, and prostate exams. * **Eye Exams:** Coverage levels vary by plan. Prime beneficiaries get one routine eye exam per year; Select beneficiaries (non-active duty family members) get one every two years.
### The "Clinical Preventive" Rule To be covered as "preventive," the visit must be for the purpose of screening or prevention in an asymptomatic patient. If you discuss a new or existing chronic problem during your "wellness" visit, the provider may bill for a separate diagnostic office visit, which could trigger a 2026 copayment based on your beneficiary group.
### Plan and Contractor Nuances * **TRICARE West (TriWest):** Effective January 1, 2025, TriWest Healthcare Alliance manages the West Region. Ensure your provider is in the TriWest network to maintain $0 costs. * **TRICARE East (Humana Military):** Beneficiaries in the East must ensure their provider is within the Humana Military network. * **Point-of-Service (POS) Option:** If you are on TRICARE Prime and see a non-network provider for preventive care without a referral, you will likely pay a POS deductible and a 50% cost-share.
## Who this affects * **Active Duty Service Members (ADSMs):** Fully covered; must coordinate through a Military Hospital or Clinic. * **Active Duty Family Members (ADFMs):** $0 copays for preventive care in-network across Prime and Select. * **Retirees and their Families:** $0 copays for covered preventive services in-network. * **Guard/Reserve:** Those on TRICARE Reserve Select (TRS) receive the same $0 in-network preventive benefit. * **TRICARE For Life (TFL):** TRICARE acts as the secondary payer to Medicare; if both cover the service, you pay $0.
## Sources * **TRICARE.mil:** [Preventive Care Services](https://www.tricare.mil/CoveredServices/IsItCovered/PreventiveCare) * **Humana Military (TRICARE East):** [Preventive Care Costs](https://www.humanamilitary.com/beneficiary/plans-and-benefits/preventive-care) * **TriWest Healthcare Alliance (TRICARE West):** [Provider Network Information](https://www.triwest.com/en/beneficiary/) * **Express Scripts:** [Pharmacy Vaccine Coverage](https://militaryrx.express-scripts.com/vaccinations)