COVID Testing Coverage

  • TRICARE covers COVID-19 tests when medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and appropriate.
  • 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.

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.
  • An active duty service member
  • A National Guard or Reserve member called or ordered to active duty service for more than 30 days
  • A service academy cadet or midshipman

And you don't have symptoms of COVID-19

 It depends. TRICARE covers the test if it's required to support your unit's readiness mission or your deployment status.
  • TRICARE covers FDA-approved COVID-19 in vitro diagnostic tests, using Reverse Transcription Polymerase Chain Reaction (RT-PCR) for asymptomatic active duty service members. Coverage is effective Nov. 1, 2019, through Feb. 28, 2021.
  • If you're an active duty service member, report your results through your unit and your medical channels.
  • Your test should be done through your service channels, or at military hospital or clinic, when possible.
  • 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.
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.

* 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.
For personal travel to other states or countries No
  • TRICARE doesn't cover testing for travel to countries (including the U.S.) 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.

>> Learn more.

Last Updated 1/14/2021