Is It Covered?
Search the A-Z list for a list of covered services. Your coverage and out-of-pocket costs may vary based on who you are and your health plan option.
- Annual physical examinations for women beginning at age 40 and at a physician's discretion for women younger than 40 who are at high risk of developing breast cancer
- Annual mammograms for women beginning at age 40, or at age 30 (or prior to September 7, 2010, the age 35) for those at high risk of developing breast cancer.
High-risk indicators include:
- Lifetime risk of breast cancer of 15 percent or greater using standard risk assessment models such as: Gail model, Claus model or Tyrer-Cuzick.
- History of breast cancer.
- Known BRCA1 and BRCA2 gene mutation.
- A parent, child or sibling with a BRCA1 or BRCA2 gene mutation and the beneficiary has not had genetic testing for this mutation.
- Radiation therapy to the chest between ages of 10 and 30.
History of LiFraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome, or a parent, child or sibling with a history of one of these syndromes.
This A-Z list of topics is not all inclusive. TRICARE covers most inpatient and outpatient care that is medically necessary and considered proven. However, there are special rules or limits on certain types of care, while other types of care are not covered at all.