TRICARE Coverage for Newborns and Kids

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Through its well-child program, TRICARE covers a variety of exams, tests, and vaccines for newborns and young children through age six. After age six, coverage will depend on which plan (Prime, Standard, etc.) you have.

However, before you can receive any TRICARE benefits you must first register in the Defense Enrollment Eligibility Reporting System (DEERS). You'll find information on DEERS enrollment here and TRICARE enrollment here.

If your child is already enrolled in DEERS and TRICARE, you're ready to begin using the following services.

Newborn Care

TRICARE covers routine newborn care while your infant is still in the hospital. This includes circumcision and screenings that are recommended by the American Academy of Pediatrics. If you've chosen to breastfeed, TRICARE also covers counseling and guidance, should you need it.

As your child grows and develops, TRICARE also covers:

  • Eye and vision screenings at birth and then again at six months of age. Beginning at age three, TRICARE covers routine eye exams that are conducted by an ophthalmologist or optometrist. Under the well-child program, this benefit is for kids through age six. If the dependent is covered under TRICARE prime he or she is eligible to receive free eye exams every two years.
  • Hearing test. The first exam usually occurs before you take your child home from the hospital. Your baby will have additional hearing screenings at each well-child exam.
  • Annual blood pressure screenings for kids between the ages of three and six.
  • Routine immunizations (see detailed list below)
  • TB test
  • A urinalysis will be conducted once during the first 12 months and once during the 2nd year.
  • Head circumference measurements for newborn through age two.
  • Blood lead test during each well-child visit that occurs beginning when your child is six months old and continuing until age six.
  • Metabolic and heredity screening
  • Dental screenings

Vaccines Covered by TRICARE

TRICARE covers routine vaccines and immunzations as recommended by the CDC. These include the following.

  • Diptheria and Tetanus (DT/TD)
  • Haemophilus Influenzae (Hib)
  • Hepatitus A Virus (HAV)
  • Hepatitis B Virus (HBV)
  • Human Papillomavirus (HPV) -- a vaccination for cervical cancer and other sexually transmitted infections.
  • Influenza A: Flu shot, inactivated.
  • Fluzone High Dose
  • Measles
  • Measles, Mumps and Rubella (MMR)
  • Measles, Mumps, Rubella and Varicella (MMRV)
  • Meningococcal: Meningitis vaccination.
  • Mumps
  • Pneumovax-23 (PPSV23): Pneumonia vaccination.
  • Prevnar-13 (PCV13): Pneumonia vaccination.
  • Poliomyelitis: Polio vaccination.
  • Rotavirus
  • Rubella (also known as German Measles)
  • Tetanus Booster
  • Tetanus, Diptheria and Pertussis (Tdap/DTaP)
  • Varicella (Chickenpox)

(Some of the immunizations such as the HPV vaccine (for boys or girls) and Tetanus booster, are for children older than age six, which means they're not part of the well-child program and coverage will depend on which TRICARE plan you have.)

Coverage of Other Health Issues/Needs

There are many other health-related issues that your child may encounter. We've listed some of the most common ones below. Whether these services are covered or not will depend on your plan. 

Allergy Testing and Treatment

  • Dermatology
  • Eyeglasses
  • Occupational Therapy
  • Oral Surgery
  • Orthopedic Braces
  • Physical Therapy
  • Speech Therapy

 

Contacting TRICARE

If you have questions regarding your TRICARE coverage, please don't hesitate to contact a representative in your TRICARE region. For your convenience the regions and their accompanying phone numbers are listed below.

North Region: 1-877-874-2273
States covered in the North Region: Connecticut, Delaware, District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin, portions of Iowa, Missouri, and Tennessee.

South Region: 1-800-444-5445
States covered in the South Region: Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee (not the Ft. Campbell area which is part of the North Region) and Texas (not the El Paso area which is part of the West Region).

West Region: 1-877-988-9378
Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (not the Rock Island Arsenal area which is part of the North Region), Kansas, Minnesota, Missouri (not the St. Louis area which is part of the North Region), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas, Utah, Washington and Wyoming.