Military families enrolled in Tricare Prime receive waiver from fees for coronavirus vaccine

The U.S. Food and Drug Administration authorized the use of the Moderna coronavirus vaccine via an emergency authorization. Millions of people enrolled in TRICARE Prime can now receive the vaccine from an outside provider without incurring fees, according to the Defense Health Agency.


By CAITLIN M. KENNEY | STARS AND STRIPES Published: February 23, 2021

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WASHINGTON — Millions of people enrolled in Tricare Prime can now receive the coronavirus vaccine from an outside provider without incurring fees, according to the Defense Health Agency.

The waiver allows enrollees — excluding active-duty service members — to receive the vaccine at a non-network Tricare provider without incurring additional service fees. Typically, a person with Prime would have to receive a referral from their doctor to receive services from another clinic. The waiver will apply to about 3.3 million Tricare Prime enrollees, according to the Military Health System website.

“The [Defense Health Agency] believes the widespread need for [coronavirus] vaccines and the fact that supply of these vaccines may be limited is a special circumstance necessitating the waiver of the referral requirement for Tricare Prime enrollees so they may receive a [coronavirus] vaccine, a clinical preventive service, from any Tricare authorized non-network provider without incurring [point of service] charges where applicable,” according to a government notice about the waiver published online Tuesday.

The waiver’s effective use has been backdated to Dec. 13 — the day before vaccines were first rolled out in the United States — and will continue until the end of the pandemic.

Tricare Prime is one of several health care plans offered to military families and retirees based on their needs and eligibility. Prime enrollees include active-duty service members and their families, retirees up to a certain age and their families, Guard and Reserve personnel and their families, as well as survivors and former spouses.

As of Tuesday, more than 1 million vaccine doses have been administered, according to John Kirby, the chief Pentagon spokesman. Of those, 684,497 are first doses and 337,910 are second doses. These initial doses are primarily going towards health care and front-line workers such as police, as well as military units about to deploy.

While the vaccine is free of charge in the United States, the waiver is a precaution in case that changes, Peter Graves, a spokesman for the Defense Health Agency, wrote in an email Tuesday.

“If that changes in the future and providers are allowed to start charging for the vaccine, this waiver will provide beneficiaries greater access to vaccines during the [coronavirus] pandemic and is consistent with the regulatory requirement that there should be no costs associated with clinical preventive services such as vaccines,” he said.

The website for the national Centers for Disease Control and Prevention also states providers can be reimbursed by insurance companies or by a government relief fund for administering the vaccine.

Twitter: @caitlinmkenney