Provisional Coverage Program

The Provisional Coverage Program covers some services and supplies.

What do I need to know about the Provisional Coverage Program?

• Pre-authorization may be required for services and supplies in the program. It doesn’t matter which TRICARE plan you’re using.
• Provisional coverage for any approved service or supply can last up to five years.
• Provisional coverage for any approved service or supply may end before five years. We’ll give timely notification of when it will end.
• We’ll determine if the service or supply becomes a permanent TRICARE benefit. We’ll do this before the five-year provisional coverage period ends.

Currently Approved for Provisional Coverage

Monoclonal antibodies in conjunction with positron emission tomography for the early stages of Alzheimer’s disease (Effective Oct. 23, 2024  through Oct. 22, 2029)

Unless you have TRICARE For Life, you must get Pre-authorizationWhen your regional contractor approves your care before you go to your appointment. If you’re being referred, your provider will get you a ReferralWhen your primary care manager or provider sends you to another provider for care that they don’t provide. and pre-authorization at the same time. to receive this treatment.