COVID Testing Coverage

  • TRICARE covers COVID-19 tests when medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition.. Do not just show up at a hospital or clinic and ask to be tested.
  • A TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS must order the test. The provider must also perform the test at a TRICARE-authorized lab or facility.
  • Your health care provider decides if you need for a test based on your exposure risk, symptoms, and guidance from the Centers for Disease Control and Prevention.
    • Your provider may screen you for COVID-19 prior to testing. This is a series of questions to discuss any symptoms.
  • There is no cost for the COVID-19 test.

At the time of posting, this information is current.

If you're Does TRICARE cover? Additional details
  • An active duty service member
  • A National Guard or Reserve member called or ordered to active duty for more than 30 days
And you have symptoms of COVID-19 or recent exposure to a person with COVID-19
 Yes
  • You should get a test at a military hospital or clinic, when possible.
  • If you're an active duty service member, report your results through your unit and medical channels.
  • If you're National Guard or Reserve member, you must show as TRICARE-eligible in the Defense Enrollment Eligibility Reporting System(DEERS) A database of information on uniformed services members (sponsors), U.S.-sponsored foreign military, DoD and uniformed services civilians, other personnel as directed by the DoD, and their family members. You need to register in DEERS to get TRICARE..
  • Your provider should reflect COVID-19 coding on the claim. Your provider processes the claim under the Supplemental Health Care Program.

A National Guard or Reserve member called or ordered to active duty for less than 30 days

 No. You aren't TRICARE-eligible.
 You'll need to get guidance from your unit regarding testing and payment. 
A National Guard/Reserve member on inactive duty No. You aren't TRICARE-eligible. TRICARE doesn't cover this.
An active duty service member or an active duty family member on Permanent Change of Station orders to an overseas location No
  • Your service covers testing under the Joint Travel Regulation if your new overseas assignment location requires testing to enter the country.
  • You'll pay any out-of-pocket costs and file a claim for reimbursement under your travel orders. TRICARE doesn't pay these claims.
An active duty service member or an active duty family member on Permanent Change of Station orders to an overseas location No
  • Your service covers testing under the Joint Travel Regulation if your new overseas assignment location requires testing to enter the country.
  • You'll pay any out-of-pocket costs and file a claim for reimbursement under your travel orders. TRICARE doesn't pay these claims.
A TRICARE For Life beneficiary It depends
A TRICARE beneficiary with symptoms Yes Your coverage is based on your provider's clinical judgement and if the test is medically necessary and appropriate.
A TRICARE beneficiary with no symptoms, and you've been exposed to a person with COVID-19 for a long period of time Yes, in some cases

Your coverage is based on your provider's clinical judgement and if the test is medically necessary and appropriate.
A TRICARE beneficiary who's having surgery, and you don't have symptoms of COVID-19 Yes, in some cases TRICARE may cover testing when the test results may affect medical management. For example, different surgical approaches or staff.
A TRICARE beneficiary who's returning to school, and you don't have symptoms of COVID-19 No* TRICARE doesn't cover this.
A TRICARE beneficiary who's returning to work, and you don't have symptoms of COVID-19 No* TRICARE doesn't cover this.
Enrolled in TRICARE Prime Remote or TRICARE Select It depends Your provider must assess your symptoms and determine if you need testing.

* TRICARE may cover tests for active duty service members if it's required for mission readiness or deployment.

 If a COVID-19 test is Does TRICARE cover? Additional details
Done overseas Yes, in some cases
  • The TRICARE Overseas Program contractor follows the established guidelines and standards of care for COVID-19 testing for the country, host nation, and/or regional health authority (e.g., World Health Organization), where you're treated. This is due to the lack of FDA-regulated tests outside the U.S.
  • TRICARE will waive copayments and cost-shares for tests the TRICARE Overseas Program contractor approves under DHA guidelines and standards.
Required for transportation (e.g. bus or vanpool) No TRICARE doesn't cover this.

For:

  • Public health surveillance
  • Research
  • Employment
  • Curiosity
 No*
  • Testing to determine antibody presence isn't considered medically necessary.
  • You should check with your employer, the party requiring the test, or local or state public health authorities for guidance.
  • You should check with whomever is requesting the test to see if you'll be reimbursed. 
In an Emergency roomThe hospital department that provides emergency services to patients who need immediate medical attention.  Yes Your coverage is based on your provider's clinical judgement and if the test is medically necessary and appropriate
Home-based  Yes  
  • TRICARE will cover an at-home COVID-19 test if it is an U.S. Food and Drug Administration-approved test ordered by an authorized TRICARE provider.
  • Each individual MTF will determine if it has capacity to process at-home tests. Contact your MTF for more information.
For personal travel to other states or countries No
  • TRICARE doesn't cover testing for travel to countries requiring COVID-19 testing or evidence of COVID-19 treatment.
  • You're encouraged to purchase travel insurance that meets coverage requirements. 

*  TRICARE may cover tests for active duty service members if it's required for mission readiness or deployment.

Notes:

  • The Secretary of Health and Human Services issued an emergency declaration that justifies the authorization of emergency use of tests for SARS-CoV-2, the virus that causes COVID-19. The FDA has to review and clear, or authorize, all SARS-CoV-2 tests for emergency use. This includes laboratory-developed tests. If a test isn’t authorized by the FDA, it can’t be used for diagnostic testing.
  • Tests may take samples from the human body. This includes swabs of mucus from inside the nose or back of the throat, or blood taken from a vein or finger stick. They detect diseases or other conditions. There are several types of SARS-CoV-2/COVID-19 related tests:
    • Diagnostic Tests. These tests detect parts of the SARS-CoV-2 virus. These include molecular tests and antigen tests.
    • Tests for Management of COVID-19 Patients. These tests detect biomarkers related to inflammation. Once patients are diagnosed with COVID-19, these additional tests can be used to make patient management decisions.
    • Serology/Antibody Tests. These tests detect antibodies (e.g., IgM, IgG) to the SARS-CoV-2 virus. Serology and antibody tests aren’t commonly used to diagnose a current infection.
  • Receiving test results can vary. Depending on testing type and site, results can be available within minutes, 2-5 days, or longer.

>> Learn more.

There’s no cost for the COVID-19 vaccine itself. But there may be a cost based on your health plan for an office visit with a provider, or if you require follow-on care. >>Learn more

Last Updated 2/9/2021