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COVID-19 Vaccine

TRICARE covers the COVID-19 vaccine in accordance with Centers for Disease Control and Prevention (CDC) guidelines. Visit the CDC website for current details. The effective date of coverage for CDC-recommended vaccines is the date Advisory Committee on Immunization Practices (ACIP) vaccine recommendations are published in a Morbidity and Mortality Weekly Report (MMWR); or if the CDC has published an interim recommendation, the effective date of coverage is the date the interim recommendation is published on the CDC website.

To help expedite claims processing, please include proof of prior vaccines, such as a copy of the patient's vaccination card or electronic health record that specifies date(s) administered, with claims submissions.

COVID-19 Vaccines

Pfizer-BioNTech

  • Effective Dec. 13, 2020, for ages 16 and older
  • Effective May 14, 2021, for ages 12 through 15
  • Effective Nov. 2, 2021, for ages 5-11 (pediatric dose)
  • Two doses in the primary series (3-8 weeks apart); three doses for those who are moderately to severely immunocompromised (third dose 28 days after second dose)

Moderna (mRNA 1273)

  • Effective Dec. 20, 2020, for ages 18 and older
  • Two doses in the primary series (4-8 weeks apart); three doses for those who are moderately to severely immunocompromised (third dose 28 days after second dose)

Janssen (Johnson & Johnson)

  • Effective Feb. 27, 2021, for ages 18 and older
  • One dose in the primary series; a second dose of either the Pfizer or Moderna vaccine may be given at least 28 days after the first Johnson & Johnson dose for those who are moderately to severely immunocompromised

Booster Doses

Visit the CDC website for current booster guidelines. Eligible individuals may choose which vaccine they receive as a booster dose, based on age and medical history. Current CDC guidelines allow for “mix and match” dosing for booster shots.

Vaccine Availability

TRICARE-covered vaccines are available at no cost to the beneficiary and may be administered at/by:

See also: TRICARE’s COVID-19 Vaccine page and the CDC’s COVID-19 Vaccination page.

Approval Requirements

An approval from Health Net Federal Services, LLC is not required. 

Reimbursement

Our claims system is updated regularly to include added Current Procedural Terminology (CPT®) and Common Procedure Coding System (HCPCS) codes. Claims may be delayed to allow for appropriate code approval and system updates.

State-Specific Websites

Each state and military installation has developed resources, including information on public access to vaccines. Click on your state or military installation below for details. 

For information about the DHA Appointing Portal (DAP) system used by some military hospitals and clinics, visit www.tricare.mil/DAP