TRICARE covers colonoscopy exams as follows:
- For individuals with hereditary non-polyposis colon rectal cancer syndrome, exams are available every two years beginning at age 25 (or five years younger than the earliest age of diagnosis of colorectal cancer, whichever is earlier), and then annually after age 40;
- For individuals who have first-degree relative diagnosed with sporadic colon rectal cancer or adenomas before the age of 60 or multiple first-degree relatives with colon rectal cancer or adenomas, exams are available every three to five years beginning 10 years earlier than the youngest affected relative.
- Once every 10 years beginning at age 50 for individuals at average risk for colon cancer.
Computed Tomographic Colonography (CTC) or (Virtual Colonoscopy) is only covered when an optical colonoscopy is medically contraindicated or can't be completed due to a known colonic lesion, structural abnormality, or other technical difficulty is encountered that prevents adequate visualization of the entire colon. CTC is NOT covered as a colorectal cancer screening for any other indication or reason.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 6/18/2020