Clinical trial (cancer)

TRICARE covers participation in National Cancer Institute-sponsored Phase I, II, and III cancer clinical trials, with pre-authorization.

Applies to: All TRICARE plans · All regions

A clinical trial is a research study that tests a treatment. TRICARE’s coverage rules for clinical trials are specific: its page covers cancer clinical trials sponsored by the National Cancer Institute (NCI).

What TRICARE covers

TRICARE covers participation in NCI-sponsored Phase I, Phase II, and Phase III studies. That includes:

• all medical care and testing needed to determine whether you are eligible for the trial;
• all medical care needed during the study, including inpatient and outpatient care, approved chemotherapy agents, and diagnostic and laboratory services;
• the screening tests used to determine eligibility and the costs of taking part.

Coverage applies to beneficiaries who are selected to participate.

How it works

Your doctor consults a cancer clinical trial case manager (through the NCI or your regional contractor), decides which phase fits you, if any, and gets pre-authorization before you take part. Selected patients get an assigned case manager.

Costs

If you are enrolled in a trial at a military hospital or clinic, TRICARE says all outpatient care is free of charge. If you are referred to a civilian TRICARE-authorized provider, you pay the same cost-share as for other covered care, which varies by who you are and which plan you use. See cost-share.

What this page does not cover

TRICARE’s page is limited to cancer trials and does not describe coverage for trials of other conditions. TRICARE generally does not cover treatments that are not proven; see what TRICARE does not cover.

Finding a trial

The National Cancer Institute’s Cancer Information Service can help at 800-4-CANCER (800-422-6237; TTY 800-332-8615), and its clinical trial search lists studies. TRICARE’s page is Cancer Clinical Trials.