WASHINGTON — As of the beginning of the year, TRICARE is offering 3D mammograms to screen for breast cancer for eligible patients.
Previously, Tricare only covered digital breast tomosynthesis in special case (i.e., after a physician order for at-risk patients or further diagnosis). Only 2D mammograms were covered for routine breast cancer screening.
The military health insurance program said it changed coverage rules because 3D mammograms have greater accuracy when detecting abnormalities and decreases false positives, which means a smaller chance of having to return for a second screening or unnecessary biopsies.
Because the benefit is covered through TRICARE’S provisional coverage program, it will require preauthorization. The program is set to expire at the end of 2024 unless the agency decides to permanently cover it at that point.
Eligible beneficiaries include patients who are at least 40 years old and women 30 and older who have an increased risk of developing breast cancer.
“Women’s health is a priority at the Defense Health Agency,” explained Elan Green, chief of the Medical Benefits and Reimbursement Section for the TRICARE Health Plan at the Defense Health Agency. “Currently, the U.S. Preventive Services Task Force hasn’t found sufficient information to develop a recommendation for or against this service. However, recognizing that 3D mammography is rapidly becoming the standard of care, the DHA approved provisional coverage of 3D mammograms for breast cancer screening.”
TRICARE will continue to cover 2D mammograms for eligible patients if requested.
