TRICARE covers annual (every 12 months with a 30 day grace period) mammograms for:
- All women age 40 or older
- Women age 30 or older who are at a 15% or greater lifetime risk of developing breast cancer
TRICARE covers 3D mammograms (digital breast tomosynthesis) for diagnostic purposes only (for example, if you have a lump and your doctor believes a 3D mammogram will be helpful in making a diagnosis). They aren’t covered for preventive screenings.
What do you consider “at high risk?”
We consider you at high risk if you have:
- A lifetime risk of breast cancer of 15% or more using standard risk assessment models.
- A history of breast cancer, Ductal Carcinoma In Situ (DCIS), Lobular Carcinoma In Situ (LCIS), Atypical Ductal Hyperplasia (ADH), or Atypical Lobular Hyperplasia (ALH).
- A known BRCA1 or BRCA2 gene mutation.
- A parent, child or sibling with a BRCA1 or BRCA2 gene mutation and haven’t had genetic testing themselves.
- Radiation therapy to the chest between the ages of 10 and 30.
- A history of Li-Fraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome, or a parent, child or sibling with a history of one of these syndromes.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryClick to closeTo 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 7/2/2019