TRICARE Chiropractic Health Care Program: Your Comprehensive Guide

Understanding TRICARE Special Programs

TRICARE, the healthcare program for uniformed service members, retirees, and their families, offers a range of Special Programs designed to address specific health conditions, population groups, and unique healthcare needs. These programs often come with particular eligibility criteria based on your TRICARE plan, beneficiary category, or status. Some are tailored for specific groups, while others provide services for particular health conditions. It’s important to note that participation in some programs may be limited by participant numbers or geographic location.

This guide will explore several key TRICARE Special Programs, with a particular focus on the Tricare Chiropractic Health Care Program.

Overview of TRICARE Special Programs

TRICARE’s commitment to comprehensive healthcare is evident in its diverse Special Programs. These programs are designed to provide targeted support and resources beyond standard benefits. Here’s a brief overview of some notable programs:

• Autism Care Demonstration: Providing applied behavior analysis (ABA) services for TRICARE beneficiaries diagnosed with autism spectrum disorder (ASD). This demonstration is ongoing until December 31, 2028.
• Cancer Clinical Trials: Covering participation in National Cancer Institute (NCI)-sponsored cancer clinical trials, including medical care, testing, and treatment during the trial period.
• TRICARE Childbirth and Breastfeeding Support Demonstration (CBSD): Offering support services such as certified labor doulas and lactation consultants for TRICARE Prime and Select enrollees. This demonstration runs until December 31, 2026, with overseas expansion planned for January 1, 2025.
• Combat-Related Special Compensation Travel Benefit: Reimbursing travel expenses for retired service members with combat-related disabilities who need to travel over 100 miles for specialty care.
• Continued Health Care Benefit Program (CHCBP): A premium-based temporary health coverage option for individuals losing TRICARE eligibility, acting as a bridge to civilian health plans.
• Extended Care Health Option (ECHO): Providing financial assistance and integrated services for beneficiaries with special needs, particularly those enrolled in the Exceptional Family Member Program (EFMP).
• Provisional Coverage Program: Covering specific services and supplies on a provisional basis, with pre-authorization required and coverage lasting up to five years. Current examples include Ablative Fractional Laser (AFL) Treatment, 3-D Mammography, and Platelet Rich Plasma (PRP) Injections.
• Transitional Assistance Management Program (TAMP): Offering 180 days of premium-free transitional health care benefits for service members and families during specific periods of separation from active duty.
• TRICARE Plus: A primary care program available at select military hospitals and clinics for TRICARE-eligible individuals not enrolled in TRICARE Prime, US Family Health Plan, or civilian/Medicare HMOs.
• Women, Infants and Children Overseas Program (WIC Overseas): Providing nutritious food, nutrition tips, health screenings, and resources for eligible participants living overseas, including civilian employees, DoD contractors, family members, and uniformed services members.

In-Depth Look: TRICARE Chiropractic Health Care Program

The TRICARE Chiropractic Health Care Program is a specialized benefit designed to provide chiropractic care to certain eligible beneficiaries within designated military medical facilities (MTFs). This program is specifically for:

• Active Duty Service Members: Those currently serving in the active military.
• Activated Guard and Reserve Members: Members of the National Guard or Reserves who are currently activated.

Eligibility and Accessing Chiropractic Care:

For active duty and activated Guard/Reserve members, accessing chiropractic care through TRICARE involves a few key steps:

1. Primary Care Manager (PCM) Consultation: The process begins with your Primary Care Manager (PCM). If you are experiencing musculoskeletal issues or pain that you believe could benefit from chiropractic treatment, your first step is to consult with your PCM.
2. PCM Assessment and Necessity Determination: Your PCM will evaluate your condition to determine if chiropractic care is medically necessary and appropriate for your specific situation. This assessment ensures that chiropractic care is the right course of treatment for your needs.
3. Medical Screening: Before a referral to a chiropractor, you will undergo a screening process. This screening is crucial to rule out any underlying medical conditions that might make chiropractic care contraindicated or require alternative treatment approaches. Patient safety is paramount, and this step ensures that chiropractic care is a safe and effective option for you.
4. Referral to a Chiropractor: If your PCM determines that chiropractic care is necessary and the screening process is clear, your PCM will issue a referral to a chiropractor within a designated military hospital or clinic. This referral authorizes you to receive chiropractic services under the TRICARE Chiropractic Health Care Program.
5. Treatment Plan and Duration: The duration and frequency of your chiropractic treatments are determined by your PCM in consultation with the chiropractor. This ensures that your care is appropriately managed and aligned with your healthcare needs and progress.

Important Note on Beneficiary Eligibility:

It’s crucial to understand that the TRICARE Chiropractic Health Care Program at military hospitals and clinics is primarily for active duty and activated Guard/Reserve members.

• Other TRICARE Beneficiaries: All other TRICARE beneficiaries, such as family members, retirees, and TRICARE For Life beneficiaries, are not eligible for direct chiropractic care within military treatment facilities under this program.

For these beneficiaries, TRICARE may offer referrals to other non-chiropractic healthcare services within MTFs, such as physical therapy or orthopedics, if deemed medically necessary by their PCM. Alternatively, these beneficiaries can seek chiropractic care in their local civilian community, but this would be at their own expense, as TRICARE does not directly cover civilian chiropractic care for these beneficiary categories.

Why Chiropractic Care?

Chiropractic care focuses on the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, particularly the spine. It’s a healthcare profession that emphasizes manual therapy, including spinal manipulation and other joint and soft-tissue manipulation. Chiropractic care is often sought for conditions such as:

• Back pain
• Neck pain
• Headaches
• Joint pain
• Sciatica

For active duty personnel, the physically demanding nature of military service can lead to musculoskeletal issues. The TRICARE Chiropractic Health Care Program provides a valuable resource for addressing these conditions, promoting readiness, and supporting the overall health and well-being of service members.

Maximizing Your TRICARE Benefits

Understanding the nuances of TRICARE Special Programs, especially the Chiropractic Health Care Program, is essential for TRICARE beneficiaries. By being informed about eligibility, access procedures, and the scope of benefits, you can effectively utilize these programs to optimize your healthcare.

If you are an active duty or activated Guard/Reserve member experiencing musculoskeletal pain, discuss the TRICARE Chiropractic Health Care Program with your PCM to explore if it’s the right option for you. For other beneficiaries, explore alternative TRICARE covered services or understand the options available for seeking civilian chiropractic care.

For detailed information on all TRICARE Special Programs, visit the official TRICARE website: https://tricare.mil/Plans/SpecialPrograms

Document Review Date: 20 March 2024