Provisional Coverage Program
The Provisional Coverage Program covers some services and supplies.
What do I need to know about the Provisional Coverage Program?
- We require pre-authorization for all 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
3-D Mammography (Digital breast tomosynthesis) (Jan. 1, 2020 through Dec. 31, 2024)
Starting Jan. 1, 2020, TRICARE will cover annual 3-D mammography screenings if you’re a woman who is:
- Age 40 or older, or
- Age 30 or older and at high risk (15% or more lifetime risk of breast cancer).
Platelet Rich Plasma (PRP) Injections (Effective Oct. 1, 2019 through Sept. 30, 2024)
TRICARE may cover PRP injections if you're diagnosed with:
- Mild to moderate chronic osteoarthritis of the knee
- Lateral epicondylitis, also known as "tennis elbow"
However, you must meet additional certain criteria for coverage. Call your regional contractor for more information.
Last Updated 12/12/2019