TRICARE covers individual provider services such as routine office visits; outpatient officebased medical and ambulatory (same-day) surgical care; consultation, diagnosis, and treatment by a specialist; allergy tests and treatment; osteopathic manipulation (except for chiropractic care); rehabilitation services, e.g., physical therapy, speech pathology services, and occupational therapy; and medical supplies used within the office, including casts, dressings, and splints. Also included are certain diagnostic radiology and ultrasound, diagnostic nuclear medicine, pathology and laboratory services, and cardiovascular studies.
Note: Additional TRICARE Prime copayments are not applied if these services are provided as part of an office visit.
TRICARE covers inpatient services as long as they are medically necessary. Hospitalization is covered in a semi-private room (or in special care units when medically necessary) and includes general nursing, hospital service, inpatient physician and surgical services; meals, including special diets; drugs and medications during an inpatient stay; operating and recovery room; anesthesia; laboratory tests; X-rays and other radiology services; necessary medical supplies and appliances; and blood and blood products.
The services listed below will be discussed in more detail:
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Adjunctive dental care
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Ambulance services
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Clinical preventive services
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Durable medical equipment (DME)
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Emergency care
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Home health care
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Hospice care
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Injectable specialty medications
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Maternity care
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Skilled nursing facility (SNF) care
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Urgent care
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Vision care
Inpatient and outpatient behavioral health care is also covered. See the Behavioral Health Care Services section of this handbook for details about covered behavioral health care services. |
