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TRICARE Standard and Extra:
Covered Services,
Limitations and Exclusions
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TRICARE Standard and TRICARE Extra cover most care that is medically necessary and considered proven. However, there are special rules or limits on certain types of care, while other types of care are not covered at all. Coverage details on the following services can be viewed in the Standard/Extra Handbook.
- Outpatient and inpatient services
- Clinical preventive services
- Behavioral health services
- Pharmacy services
- Maternity services
- Dental services.
Services or Procedures with Significant Limitations
A list of medical, surgical, and behavioral health care services that may not be covered unless exceptional circumstances exist is shown in the Standard/Extra Handbook. Exclusions
In general, TRICARE excludes services and supplies that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness (including mental disorder) or injury or for the diagnosis and treatment of pregnancy or well-baby care. All services and supplies (including inpatient institutional costs) related to a non-covered condition or treatment, or provided by an unauthorized provider, are excluded. A list of exclusions can be viewed in the Standard/Extra Handbook. |
