Is TRICARE Preventive Care Covered? 2026 Rates & Rules
*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy, visit TRICARE.mil.*
## Quick answer TRICARE covers most clinical preventive services with **$0 out-of-pocket costs**, provided you see an in-network provider. This includes annual "Wellness Exams," immunizations, and cancer screenings (like mammograms and colonoscopies) that meet age and frequency guidelines.
Details
### No-Cost Preventive Services For most beneficiaries, preventive care is considered "high-value" care. Under the Affordable Care Act rules applied to military health, you will pay $0 for these services if you stay in-network: * **Annual Well-Woman Exams:** Pelvic exams, PAP tests, and clinical breast exams. * **Annual Physicals:** Covered for all TRICARE Prime enrollees. For TRICARE Select, one "Wellness Exam" is covered annually per person. * **Immunizations:** All CDC-recommended vaccines (Flu, COVID-19, HPV, etc.). * **Cancer Screenings:** Mammograms (starting at age 40, or earlier if high-risk), Colonoscopies (starting at age 45), and Prostate exams (starting at age 50). * **Well-Child Care:** Comprehensive pediatric visits from birth through age 6.
### The "Office Visit" Catch While the preventive procedure itself (like a flu shot or a PAP smear) is $0, you may be charged a copayment if the doctor addresses a **new or existing medical problem** during the same appointment. For example, if you go in for a 2026 wellness exam but also ask the doctor to look at a painful knee injury, the visit may be coded as a diagnostic office visit rather than a preventive one.
### Plan-Specific Rules (2026) * **TRICARE Prime:** Preventive care must be coordinated through your Primary Care Manager (PCM). There is never a copay for clinical preventive services. * **TRICARE Select:** No copay for preventive services from an **In-Network** provider. However, if you see an Out-of-Network provider, you will be responsible for the standard deductible and cost-shares (varies by Group A/B status; check TRICARE.mil for specific 2026 tier rates). * **Point-of-Service (POS):** If you are on Prime and see a provider other than your PCM for preventive care without a referral, you may trigger POS charges, which include a high deductible.
### Regional Management As of 2026, these services are managed by: * **East Region:** Humana Military. * **West Region:** TriWest Healthcare Alliance. * **Pharmacy (Vaccines):** Express Scripts (available at participating retail pharmacies).
## Who this affects * **Active Duty Service Members (ADSMs):** Fully covered; required for readiness. * **Active Duty Family Members (ADFMs):** Covered via Prime or Select with $0 copays in-network. * **Retirees and their Families:** Covered; $0 in-network. * **National Guard & Reserve:** Covered under TRICARE Reserve Select (TRS). * **Survivors:** Benefits remain consistent with retiree or active duty family status.
## Sources 1. **TRICARE.mil:** [Preventive Care Services](https://www.tricare.mil/CoveredServices/IsItCovered/PreventiveCare) 2. **Humana Military (East):** [Preventive Services Guide](https://www.humanamilitary.com) 3. **TriWest Healthcare Alliance (West):** [Preventive Care Overview](https://www.triwest.com) 4. **Health.mil:** [DHA Wellness Exam Guidance](https://health.mil)