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News | May 15, 2023

How COVID-19 Public Health Emergency’s End Affects TRICARE

By TRICARE Communications

The Public Health Emergency (PHE) for COVID-19 expired at the end of May 11. You might be wondering what this means about the state of COVID-19 or if there are changes to your TRICARE coverage.
 
“COVID-19 is still a public health threat in the U.S. and around the world,” said Elan Green, chief of TRICARE Health Plan’s Member Benefits and Reimbursement Section. “But widescale efforts to mitigate the worst impacts of COVID-19 have helped us reach a point where we’re no longer in a state of emergency.”
 
Most Department of Defense COVID-19 activities won’t be directly affected by the end of the PHE. For example, you’ll still have access to COVID-19 vaccines, testing, and treatments through TRICARE. And many telehealth services are now a permanent TRICARE benefit. But keep these changes in mind:
  • COVID-19 Testing: You may have a cost-share for COVID-19 testing. TRICARE only covers COVID-19 tests that are medically necessary and ordered by a TRICARE-authorized provider. If you have TRICARE For Life, learn how Medicare coverage of COVID-19 testing is changing.
  • Telehealth: To help protect your privacy, all providers must now use HIPAA-compliant telehealth platforms.
  • Clinical Trials: Temporary coverage of National Institute of Allergy and Infectious Diseases–sponsored COVID-19 clinical trials ended April 10. If you were enrolled in a covered trial on or before April 10, your care will be covered through the end of the trial.
  • Skilled Nursing Facilities: A temporary waiver of the requirement for a three-day prior hospital stay before admission to a skilled nursing facility ended for new admissions after April 10.
 
Protect yourself from COVID-19
It’s still important to take steps to help protect yourself and others. Vaccines are still the most effective tool to prevent serious illness, long-term effects, and death from COVID-19—even if you’ve had COVID-19 in the past.
 
Are you and your family up to date with COVID-19 vaccines? As outlined in recently updated CDC guidance:
  • Everyone 6 years and older is up to date if they’ve received 1 updated (bivalent) Pfizer-BioNTech or Moderna COVID-19 vaccine, regardless of whether they’ve received any original COVID-19 vaccines. If you’re 65 or older, you may get a second dose of the updated vaccine.
  • Children ages 6 months through 5 years should get 1 or more doses of the updated vaccine, depending on their age and which COVID-19 vaccines they’ve already received.
 
Go to the CDC website to learn more about COVID-19 vaccine recommendations and benefits of getting vaccinated. Your health care provider can give you guidance on when you should get the updated vaccine.
 
You have options for where you can get an updated COVID-19 vaccine. These include:
  • Military hospitals, clinics, and vaccination sites
  • Local or state health department vaccination sites
  • Your civilian provider
  • Pharmacies participating in the Federal Retail Pharmacy Program, participating pharmacies, and vaccination sites, which can include local convenience store chains and grocery stores
 
You can get updated COVID-19 vaccines at no cost. But you may have costs for an office visit or if you need follow-on care. Your out-of-pocket costs would be based on your TRICARE health plan.
 
To learn more about your options for COVID-19 vaccines, check out COVID guidance for TRICARE beneficiaries. If you have coverage questions, you can call your TRICARE contractor.
 
Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.
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