TRICARE FAQs: COVID-19 and Testing

7/6/2020

Proper testing can help you slow the spread of the coronavirus. As you learn more about how to protect yourself—and the health of others—you may have questions about your TRICARE benefit. You can find answers to your frequently asked questions (FAQs) and more on the TRICARE Coronavirus FAQs page.

The following are some of the most frequently asked questions about testing and COVID-19:

Question: Should I get tested for COVID-19?

Answer: You should get a test if you’re experiencing COVID-19 symptoms. Be sure to contact your health care provider if you feel sick or recently had close contact with someone infected with COVID-19. Based on guidance from the Centers for Disease Control and Prevention (CDC), your provider will use a screening process to determine whether you need to be tested. He or she will assess your symptoms and risk of exposure during the screening.

If you do need a test, your local military hospital or clinic may be able to provide you with one. In a June memo on COVID-19 testing, Under Secretary of Defense for Personnel and Readiness Matthew P. Donovan explained that the Department of Defense (DoD) is closely following CDC guidance for safe testing. “Health care providers will use their clinical judgement to guide diagnostic testing for COVID-19,” wrote Donovan. “DoD components must ensure appropriate infection prevention and control procedures are followed throughout the entire testing process.”

The memo also indicated that military hospitals and clinics may provide tests for:

  • Service members 
  • DoD civilian employees who aren’t DoD health care beneficiaries. Your supervisor must determine if you’re urgently required to be in your DoD workplace.
  • Family members who are DoD/TRICARE eligible beneficiaries.

Do you have a civilian provider? If so, TRICARE will cover the costs of the test if your provider determines it’s medically appropriate and the requests meets the screening criteria. To learn more about testing, check out the COVID-19 Testing FAQ topic or visit the CDC website. If you think you may have COVID-19, you can also check your symptoms using the Coronavirus Symptom Checker.

Question: What, if any, copayments will be waived related to COVID-19 treatment and testing? How does this apply to active duty, reserve component, and retirees?

Answer: The actual COVID-19 test is free. Under the Families First Coronavirus Response Act, TRICARE will also waive your copayments for doctor-ordered COVID-19 office visits. This law doesn’t waive your copayments and cost-shares for treatment due to infection. For example, if your doctor prescribes you medication after the test, your TRICARE plan cost-shares or copayments would still apply. By law, TRICARE can’t waive your pharmacy copayments. But you can save money by filling your prescription at a military pharmacy or by using TRICARE Pharmacy Home Delivery.

Are you located overseas? If you have cost-shares, you may be eligible for cost-shareA percentage of the total cost of a covered health care service that you pay. waivers. Your COVID-19 test and visit must meet the requirements of the coronavirus law passed by Congress. Your test has to be FDA approved, cleared, or authorized. Some tests used may not meet this statutory requirement. This includes the World Health Organization test, which isn’t currently FDA authorized. Be sure to contact your regional contractor if you have questions.

Question: Are retirees using TRICARE For Life and Medicare covered for COVID-19 testing and treatment?

Answer: Medicare Part B covers the lab tests for COVID-19. You pay no out-of-pocket costs for this service. Medicare also covers all medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. hospitalizations. This includes if you’re diagnosed with COVID-19 and need to stay in the hospital under quarantine. Do you have a Medicare Advantage Plan? If so, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Be sure to check with your plan about your coverage and costs. If you’re enrolled in TRICARE For Life, keep in mind that TRICARE acts as second payer for Medicare and TRICARE covered services. This includes COVID-19 testing and hospitalization. You can find more information about this by going to the TRICARE Benefit FAQ topic or by visiting the Medicare website.

If you have questions about costs related to certain services, remember you can refer to the TRICARE Costs and Fees Fact Sheet. This resource describes a number of the costs for various health visits.

For more on COVID-19 FAQs, check out ones on quarantine, telemedicine, and elective procedures. As you continue to ask important questions, TRICARE is committed to getting you answers. Stay safe, and stay informed.

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Last Updated 7/6/2020