What Does TriCare’s ‘Well-Child Care’ Cover?

What Does TriCare’s ‘Well-Child Care’ Cover?

TriCare Well-Child Care Coverage

TriCare is a major part of the Military Health System. This health plan provides quality health care services to active duty military men and women, including the National Guard and Reserves, as well as their families. This results in TriCare covering nearly 10 million beneficiaries worldwide. Some of their coverage includes dental, vision, preventative care, prescriptions and provisions for individuals with special needs. Most importantly, TriCare covers well-child care checkups.

TriCare offers well-child care coverage for newborns up to age six. They cover most inpatient and outpatient needs. There are some instances where you may reach a limit on certain coverage or find that others may not be covered at all. Coverage and out-of-pocket expenses depends on the individual’s eligibility. To be eligible participants must be registered with the Defense Enrollment Eligibility Reporting System.

Birth-2 year Coverage

At birth, the hospital will perform routine care that will include monitoring weight, height, and head circumference, as well as hearing tests and circumcisions. Once the baby is home, Parents are required to attend well-child care checkups. There are normally five to six checkups in the baby’s first year and three checkups during the second year. During these checkups the doctors will:

  • Monitor weight and height
  • Head circumference up to age two
  • Vision screenings at birth and 6 months
  • Hearing check
  • Tuberculin test at 12 months and 2 years
  • Hemoglobin or hematocrit test at 12 months and 2 years
  • Urinalysis at 12 months and 2 years

3 years-6 years Coverage

After the second year, parents are only required to schedule an annual well-child care checkup. These checkups are similar to the first couple of years which include weight, height and dental screenings. Also included in this age group are:

  • Annual blood pressure screening
  • Routine eye exams every two years that will also screen for amblyopia and strabismus

Other Coverage

Other coverages that will occur during both age groups’ well-child care checkup include routine immunizations, physical exams for school and mental health assessments. Blood lead testing will take place at each visit from ages 6 months to 6 years. Health counseling services are also included that cover the benefits of breast feeding and other nutritional information for the child. If there is additional health care needed for other medical findings they may also be covered. Some situations may require a primary doctor’s referral. Out of pocket expenses can range from $1,000 to $3,000 per family each year depending on the coverage eligibility.

Peter Wendt is a freelance writer from Austin, TX. Peter has two children and enjoys writing about child health care. If you, or a loved one, are trying to find a TriCare provider, Peter highly recommends Kangos Pediatrics.

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