The TRICARE Entitlement Program: How you can make it work for you?

 September is Health Benefits Awareness Month, and it is important for you and your family to have the best health possible. So, for the next four weeks, we will focus on different facets of health: physical, mental, dental and travel health.

• Physical Health: TRICARE covers most inpatient and outpatient care that is medically necessary and considered proven. Equally important to primary care is preventive health care, which can help you live a healthier, longer life. As a TRICARE beneficiary, you are eligible for a range of clinical preventive services, including examinations, immunizations and periodic screenings based on your age, health history and family history. Coverage varies for prime and standard beneficiaries, so it is best to double check your specific benefit.  
• Comprehensive Health Promotion and Disease Preventive Examinations: One comprehensive disease preventive clinical evaluation should be accomplished for people 2 years and older.
• Targeted Health Promotion and Disease Prevention Examinations: The following screening examinations may be performed during either the above periodic comprehensive health promotion examination or as part of other patient encounters.

Cancer screenings – Not all insurances pay for various preventive screenings. TRICARE leads the way in providing a robust preventive health screening opportunity for both TRICARE Prime and TRICARE Standard. Female screenings include breast cancer screenings with physical exam and mammogram every 12 months for women 39 years and older (younger if there is a family history of breast cancer.) Pap examinations are annual starting at 18 years old. Male screenings include testicular exams for males starting from 13 to 39 years old with a history of cryptorchidism, orchiopexy or testicular atrophy. A prostate cancer examination is offered annually for all men starting at age 50 (earlier if there is family history of prostate cancer). The screenings include physical exam and prostate-specific antigen. Colorectal cancer exams for both men and women start at age 40 with physical exam and occult blood tests every year. Sigmoidoscopy exams should be done every three to five years starting at age 50 and colonoscopy every 10 years starting at age 50.

Cardiovascular screenings – Everyone should get a cholesterol – lipid panel at least every five years starting at age 18. Blood pressure checks should be done at least every two years.

Vision screenings – Active duty family prime enrolled beneficiaries
3 years and older are authorized one comprehensive eye exam by a specialist every year. Infants are screened by their primary care provider at birth and at 6 months. Children who are standard beneficiaries between the ages of 3 and 6 years are authorized two comprehensive eye exams by a specialist. Adult standard beneficiaries are not covered for visual screenings.

Immunizations and vaccines – Shingles (Herpes Zoster) for 60- to 65-year olds; Human papillomavirus (HPV) for girls 11 to 12 years old, or catch up for girls 13 to 26 years old.

This is not an all inclusive list of the clinical preventive services offered by TRICARE, so check with your primary care provider to ensure you are up to date on the appropriate screenings for you and your family.
(Courtesy of TRICARE)