TRICARE beneficiaries in 10 states are eligible to take part in TRICARE’s Low Back Pain and Physical Therapy Demonstration, which will waive cost shares for up to three therapy sessions.
To participate, beneficiaries must be diagnosed with low back pain after Jan. 1, 2021 and have a referral from a TRICARE-authorized provider to another TRICARE-authorized, in-network provider. TRICARE For Life beneficiaries only need to see a TRICARE-authorized provider, per TRICARE.mil guidance.
The program is available to those who live in and seek care in one of the following states:
- North Carolina
[RELATED: MOAA’s 2020-21 TRICARE GUIDE]
Cost shares are waived for the first three covered physical therapy sessions. Point-of-service fees are not waived for TRICARE Prime users. Beneficiaries must pay standard cost shares for any subsequent sessions.
The program is slated to run through the end of 2023, but may be extended or cut short, per the website. It was first announced in July 2020.
The program officially kicked off around the same time the FY 2021 National Defense Authorization Act (NDAA) took effect; NDAA report language includes separate instructions that direct the Defense Health Agency to brief Congress on the expected date of chiropractic coverage within 180 days of enactment of the NDAA.
MOAA has long fought to close this coverage gap – chiropractic care has become standard for private-sector health plans as a needed form of pain management, reducing the over-reliance on drugs to treat some chronic issues.
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