Colonoscopy Screening Benefit Expanded

The Department of Defense continues to enhance the TRICARE benefit to provide the most comprehensive and quality care to your patients. A recent TRICARE policy change will now allow coverage for one routine colonoscopy screening every 10 years for beneficiaries beginning at age 50. Screenings are also covered in the following situations:
     

A colonoscopy should be performed every two years beginning at age 25, or five years younger than the earliest age of diagnosis of colorectal cancer, whichever is earlier. Annual screenings should then occur after age 40.
      

A colonoscopy should be performed every three to five years beginning 10 years earlier than the youngest affected relative. Familial risk means that a history of first-degree relative (such as, a father, mother or brother) under age 60 with sporadic colorectal cancer or adenomas or multiple first-degree relatives with colorectal cancer or adenomas.

Other routine colonoscopy screenings are not covered by TRICARE.

Note: If your patient is a TRICARE beneficiary and eligible for Medicare, a routine colonoscopy will most likely be covered separately by Medicare.