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Screening Guide
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Dental Exam

  1. Why Regular visits to the dentist will help identify any tooth or gum problems before they progress. Keeping teeth clean will reduce the amount of tartar and plaque build-up that can lead to tooth decay and gum disease.
  2. What The dentist or dental hygienist will inspect the teeth as well as the soft tissue of the mouth (gums, tongue, cheeks and palate). X-rays may be taken and each visit usually includes a cleaning. Gums are checked for gingivitis (inflamed, swollen or bleeding gums). The head, neck and jaw may also be examined.
  3. When Dental visits should begin within six months of a child's first tooth and no later than the first birthday. Regular visits should occur every six months throughout childhood and adulthood.
  4. Where Dentists will provide regular check-ups and cleanings. At-home tooth care is also important. The American Dental Association recommends brushing your teeth twice a day with fluoride toothpaste and flossing daily.
  5. TRICARE benefit information

    The TRICARE dental program is a voluntary, premium-based dental insurance plan. TriWest does not administer the TRICARE dental program.

Testicular Self-exam

  1. Why Testicular cancer is the most common cancer in men between the ages of 15 and 34 and is among the most curable when caught early. Self-exams can give men a chance to discover any lumps or irregularities that may indicate testicular cancer. If you have certain lifestyle, age, ethnicity or hereditary risk factors for testicular cancer, exams should be a part of your regular wellness routine.
  2. What Men performing a testicular self-exam should be looking for lumps or changes in size, shape or consistency of the testicles. Begin by visually inspecting the skin on your scrotum for swelling. Use both hands to inspect the testicles, while holding the penis out of the way. Gently roll the testicle between your index and middle fingers of both hands to note any lumps or changes in size, shape or consistency. The process should be repeated with each testicle. Tell your doctor about any lumps or other irregularities. Finding something does not automatically mean you have cancer; there are non-cancerous conditions that may cause bumps or swelling as well. Testicular cancer lumps are usually found on the sides of the testicles, but they can also develop on the front. You should not feel any pain while performing the exam.
  3. When After puberty, men (particularly those with risk factors for testicular cancer) may benefit from performing monthly testicular self-exams.
  4. Where Testicular self-exams are best performed while standing in front of a mirror. Heat, after a warm shower or bath, helps to relax the scrotum, making it easier to notice any irregularities.

Digital Rectal Exam

  1. Why The most direct way for a physician to screen for prostate and colorectal cancer is through a digital rectal exam. Your doctor may also examine other organs, such as the bladder, during a digital rectal exam.
  2. What During a digital rectal examination, your doctor will use a lubricated, gloved finger of one hand to check for problems with organs or other structures in the pelvis and lower belly. Their other hand maybe used to press on the lower belly or pelvic area.
  3. When Men aged 50 and over, or earlier for those at high-risk for cancer, may benefit from an annual digital rectal exam.
  4. Where Your doctor can perform the examination as part of a regular physical exam once you reach the appropriate age.
  5. TRICARE benefit information

PSA Test

  1. Why Healthy men have low amounts of prostrate-specific antigen (PSA) in their blood and the PSA levels may rise naturally as men age. The prostate gland releases PSA as it enlarges, which means an enlarged prostate maybe an indicator of prostate cancer. If found early enough, it is curable. Talk with your doctor about whether a PSA test is right for you.
  2. What The PSA test is a blood test measuring the amount of PSA in a man's blood.
  3. When Men over age 50 should have annual screenings. For increased accuracy, the PSA test can also be given in conjunction with a digital rectal exam.
  4. Where Your doctor will help you schedule a PSA test.
  5. TRICARE benefit information

Pap Smear

  1. Why A Pap test can detect the earliest signs of cervical cancer. Pap tests also can find infections and identify abnormal cervical cells that can turn into cancer cells. If caught early, treatment can prevent most cases of cervical cancer from developing.
  2. What The Pap test, also called a Pap smear, checks for changes in the cells of your cervix that may develop into cervical cancer. The doctor will then take a few cells from inside and around the cervix. While usually painless, a Pap test can be uncomfortable for some women.
  3. When Women should have their first Pap smear three years after first having sex, but no later than age 21. The test should be performed every year until the age of 30.

    Women aged 30 to 65 should have the test every two or three years after three consecutive normal Pap smears.

    Women aged 70 and over can stop having Pap smears after three consecutive normal Pap smears without any abnormal Pap smears in the last 10 years.

    Women with certain risk factors (health or family history) may require more frequent screening.
  4. Where Your doctor can perform a Pap test during a routine pelvic exam.
  5. TRICARE benefit information

Clinical Breast Exam

  1. Why Clinical breast exams help physicians uncover breast cancer in its early stages. Detecting breast cancer early can significantly increase a patient's odds for survival. Breast cancers caught during screening are usually smaller and less likely to have spread.
  2. What During a clinical breast exam, a doctor or other health care provider feels the breasts and underarms for lumps and other changes. The health care provider performing the exam first checks the breasts for differences in size or shape. The skin on the breasts is also evaluated for abnormalities, such as a rash or dimpling. The lymph nodes near the breasts will also be checked for enlargement. The entire process takes about five to ten minutes. Women do not typically experience pain or discomfort during a clinical breast exam.
  3. When Women in their 20s and 30s should have a clinical breast exam as part of a regular exam by a health professional, preferably every three years. Women aged 40 and over should have a clinical breast exam every year.
  4. Where A clinical breast exam can be scheduled as part of your regular health exam with your doctor or health care provider.
  5. TRICARE benefit information

Breast Self-exam

  1. Why The goal of a breast self-exam is to report any changes in the breast that may be indicative of breast cancer to a doctor or nurse as soon as possible. The earlier potential cancer can be found, the greater chance there is for a successful treatment.
  2. What A breast self-exam is a technique for you to check your breasts and underarms for indications of breast cancer. You should use a combination of visually examining your breasts for dents, odd coloring or swelling and feeling for a lump, ball, a thickened band or a deep, hard area in the breast tissue. The best positions for inspecting are leaning forward with your arms tightly on your hips and standing upright with both arms over your head. Both breasts should look the same, especially around the nipple.

    The American Cancer Society recommends using a vertical pattern to examine the breast to ensure that the entire area is covered. The palm surface of the fingers should be used, not the tips, to move the breast. Your exam will need to include the area under your arms, since the breast tail extends into the armpit and you should also look for any lumps or enlarged lymph nodes under the arm as well.

    You should notify your doctor as soon as possible about any irregularities you find, but realize some changes may be non-cancerous.
  3. When Beginning in their 20s and continuing throughout life, women are encouraged to perform a monthly breast self-exam. The American Cancer Society recommends that women who choose to perform breast self-exams have their technique reviewed by a doctor or other health care professional during a regular physical exam.
  4. Where Breast self-exams are not a substitute for mammography or regular exams conducted by a healthcare professional. Be sure to keep regular appointments as recommended by your healthcare provider.

Bone Density Test

  1. Why Osteoporosis is a disorder that causes bones to become porous, weak and brittle. Bone density tests are usually performed on bones that are likely to break due to osteoporosis: the bones in the hip and lower spine. Typically affecting older adults, osteoporosis occurs when low levels of calcium, phosphorus and other minerals cause bones to lose mass, making them brittle and susceptible to breaking. Lower levels of estrogen can also weaken the bones.
  2. What Bone density tests, or bone mineral density tests, are non-invasive tests used to measure bone density. Your bone health can be measured using several different types of machines. Large scanners called central machines may be used to measure density in the hips, spine and throughout the whole body. Peripheral machines can be placed on your fingers or other extremities and will measure bone density in your fingers, wrists, kneecaps, shins and heels.

    The most popular bone density test is dual energy x-ray absorptiometry (DEXA). The radiation dose is approximately 1/10th that of a standard chest x-ray. The varying amounts of x-rays that pass through the different bone regions are measured and then displayed as a color image that reveals your bone density.

    Density is measured as either a T-score (your density measured from a baseline of a 30-year-old healthy adult or the same gender) or a Z-score (density measured from an average density according to age, gender and size).

    If a low score is found, prescription drugs may help slow any bone loss and might even increase bone density. Increasing your intake of dietary calcium and getting regular exercise can help prevent the chance of bone fractures due to low bone density.
  3. When Women over age 65 should have a bone density test to screen for osteoporosis. If there are risk factors present, younger postmenopausal women should have earlier screenings, as should postmenopausal women who suffer fractures.
  4. Where Your doctor or health care provider can schedule a screening or may refer you to a specialist.
  5. TRICARE benefit information

Mammogram

  1. Why According to the Center for Disease Control and Prevention, mammography is the best available method to detect breast cancer in its earliest, most treatable stage an average of one-to-three years before a woman can feel a lump. Breast cancer found in its earliest stages offers the greatest chance of remission and survival.
  2. What A mammogram is an x-ray of the breast that is used to detect and diagnose breast cancer. Having a mammogram requires you to undress above the waist. A wrap will be provided for you to wear. A technologist will position your breasts on the machine for the mammogram.

    Women who have no reported breast problems are given a screening mammogram. Screening mammography usually involves two x-ray pictures of each breast. Some patients, including women with breast implants, may need additional pictures to include as much breast tissue as possible.

    During a mammogram, the breast is pressed between two plastic plates attached to the mammogram machine. Pressing the breast spreads the tissue apart and ensures that there is very little movement. The result is a sharp black and white image that will be interpreted by a radiologist. The entire process for a mammogram takes about 20 minutes.

    It's normal to feel some discomfort when your breasts are compressed. Tell your technician if you are in any pain. Try not to schedule a mammogram when your breasts are tender.
  3. When The American Cancer Society recommends that "women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health." Detecting breast cancer as early as possible improves the chances of successful treatment
  4. Where You should coordinate with your doctor or health care provider to schedule your mammogram.
  5. TRICARE benefit information

Hearing Test

  1. Why Hearing tests are used to identify any loss of hearing or ear-related problems. Ear problems can be signs of health, development or communication issues.
  2. What Newborns are likely to be given an electrophysiologic test, measuring a child's hearing ability based on electrical information from the auditory nervous system. Pure tone audiometry, the standard method of testing for children ages four through adulthood, requires patients to press a button, raise a hand or point to the appropriate ear when hearing a sound through earphones or speakers. The eardrum's response to soft sounds or air pressure in the ear canal might also be measured. A visual inspection of the ear might also be included. Patients do not usually experience pain or discomfort during a hearing test.
  3. When Newborns might have a hearing test before leaving the hospital or maternity center. If not, your child should have a hearing test before the age of three months. Before your child enters school, hearing should be monitored twice a year. Screening for school-aged children can help identify any issues that may impair development or communication. Adults should have a hearing test at least once every ten years through age 50,and every three years thereafter.
  4. Where Children may receive hearing tests as part of their regular medical exams or as mandated by their school district or state's education department. A hearing care professional, with the help of a hearing test, determines whether or not hearing loss is present. If hearing loss is determined to be present, you may be referred to a specialist for further assessment.
  5. TRICARE covers hearing exams under well-child care for eligible children up to age six. Read more on well-child care.

Vision Test

  1. Why Taking care of your eyes and getting regular examinations can prevent many leading causes of blindness and can help correct poor vision.
  2. What One important aspect of a vision test is the test of visual acuity, or ability to see over distances. You may be asked to read letters off an eye chart. For young children, the letter "E" is projected and the child points in the direction that the "E" is facing. Eye movement and visual field are tested by moving a light or object through the field of vision. Your eyes’ reaction to light will also be noted.

    The optometrist or ophthalmologist may test for cataracts or other clouding of the eye lens by holding an ophthalmoscope up to your eyes. The pupil may be dilated with eye drops to give the doctor a better view of the back of the eye.

    A puff of air may be blown into the eye to measure fluid pressure and detect glaucoma. A low-power microscope combined with a high-intensity light source provides a highly magnified view of the structures of the eye.
  3. When Children under the age of three should have an eye screening during regular pediatric appointments. Vision testing is recommended for children at age three and again when they start school. Children with a family history of eye conditions or exhibiting signs of vision or eye problems should be checked regularly. Even if there are no problem indicators, the American Optometric Association suggests school-aged children have their vision checked every two years. Adults up to age 40 should be checked out every two-to-three years. Adults over the age of 40 should have their vision checked every other year or more frequently if there are other health concerns, such as diabetes or high blood pressure.
  4. Where Eye screenings may be given by an ophthalmologist (a physician who specializes in medical and surgical treatment related to eye disease and disorders). A doctor of optometry specializes in diagnosing and treating vision problems and will usually identify and work to correct any visual acuity issues.
  5. TRICARE benefit information

Well-Child Care

  1. Why Well-child visits help physicians screen for diseases and assess a child's risk for future health problems. It is better to treat a condition early before it becomes worse.
  2. What Well-child visits are medical evaluations in which a physician examines various organ systems and other parts of a child's body to make sure he or she is developing normally and in good health. Well-child care (birth to six years) includes routine newborn care; comprehensive health promotion and disease prevention exams; vision and hearing screenings; height, weight, and head circumference; routine immunizations; and developmental and behavioral appraisal in accordance with the American Academy of Pediatrics (AAP) and CDC guidelines.

    Children under 24 months in age are covered under TRICARE's well-baby benefit, which includes routine care after delivery, a variety of tests, newborn male circumcision, and up to nine well-baby visits over a two-year period. The visits include such things as history, physical exam, a behavioral health assessment, and a developmental and behavioral evaluation.

    School enrollment physicals are covered for children ages five to 11 years, but annual sports physicals are not covered.
  3. When Beginning immediately after birth, newborns should be evaluated for any potential health problems. TRICARE's well-child and well-baby benefit covers your child's preventive care from birth to six years old and school physicals from age five to 11.
  4. Where Your child's pediatrician will be able to coordinate well-baby and well-child care.
  5. TRICARE benefit information

HIV/STD Screening

  1. Why STDs (sexually transmitted diseases) refer to a variety of bacterial,viral and parasitic infections that are acquired through sexual activity. Common STDs include: chlamydia, gonorrhea, hepatitis B, herpes, HIV, HPV (human papillomarvirus) and syphilis.

    Many STDs affecting women show no early signs or symptoms. Without finding the infections through screenings, women with undetected STDs may go untreated until complications arise. Pregnant women with STDs are at greater risk of miscarriage and premature delivery. In some cases they can also transmit the infection to their babies.

    The Centers for Disease Control and Prevention suggests that anyone who can answer yes to any of the following questions should be tested for HIV:

    • Have you injected drugs or steroids or shared equipment (such as needles, syringes, works) with others?
    • Have you had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners?
    • Have you exchanged sex for drugs or money?
    • Have you been diagnosed with or treated for hepatitis, tuberculosis (TB), or a sexually transmitted disease (STD), like syphilis?
    • Have you had unprotected sex with someone who could answer yes to any of the above questions?
  2. What The goal in screening for HIV and STDs is to take care of any condition that might be present and to protect other people from becoming infected. Usually a blood test, or a series of blood tests, these screenings may also include education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors and the evaluation, treatment, and counseling of sex partners of persons who are infected with an STD.

    Your doctor or health care provider may also ask you about your sexual history and try to determine if there are any high-risk behaviors present. If your doctor feels you are at risk for a vaccine-preventable STD (hepatitis A, hepatitis B or HPV, for example), you may be prescribed a pre-exposure vaccine.
  3. When Women who are or who may become pregnant should be screened as part of a pre-natal check up. Screening for STDs should take place before and after becoming sexually active. If you engage in certain risky behaviors, you should be screened regularly to help reduce the possibility of unknowingly spreading infection.

    Most HIV tests are antibody tests that measure the antibodies your body makes against HIV. It can take some time, referred to as the "window period," for the immune system to produce enough antibodies for the antibody test to detect. Most people will develop detectable antibodies within 2 to 8 weeks (the average is 25 days). There is a chance that some individuals will take longer to develop detectable antibodies. If the initial negative HIV test was conducted within the first 3 months after possible exposure, you may want to consider repeat testing to account for a possibly longer "window period."
  4. Where The Centers for Disease Control and Prevention has established a database of local resources for HIV/AIDS testing at the National HIV Testing Resources. Your doctor or health care provider will have additional testing resources available to you.
  5. HIV screenings are not a covered benefit

Blood Pressure Test

  1. Why Left untreated, high blood pressure will cause the heart to eventually overwork itself and may cause serious damage. High blood pressure is considered a major risk factor for heart attack, heart failure and stroke. High blood pressure can damage arteries in the brain, the eyes and the kidneys.
  2. What Blood pressure tests begin with wrapping an arm cuff around your arm. Your doctor or nurse listens to the artery located at the inside elbow on that arm through a stethoscope. The doctor pumps the cuff full of air until circulation is very briefly cut off. As the air is let out, the examiner waits for the first heartbeat they can hear. This number is the systolic pressure (the upper number of your heartbeat).

    The doctor or nurse continues to watch the monitor as the numbers continue to fall, noting when he or she hears the last heartbeat. That number is the diastolic pressure. Blood pressure is expressed as systolic pressure over diastolic pressure.

    There is no cure for high blood pressure, but it can be managed and controlled with diet and medication. Individuals at risk are typically not prescribed medication, but are advised to make changes to their diet and exercise to help keep blood pressure from rising.
  3. When Men and women aged 18 and older should be screened for high blood pressure at least once every two years. More frequent screenings may be required if you have a family history of cardiovascular disease.
  4. Where Your doctor will most likely check your blood pressure as part of a regular examination.
  5. TRICARE benefit information

Cholesterol Test

  1. Why Testing for cholesterol can give you important information about your risk of developing a heart-related medical condition. High blood cholesterol can be one sign of an unhealthy heart, but does not cause any symptoms on its own. Your doctor will suggest lifestyle changes, such as diet and exercise, or medications to help control an unhealthy cholesterol level.
  2. What A cholesterol test is actually a group of blood tests that measure the types and amounts of lipids (fats or fat-like substances) in your bloodstream. Your doctor will be able to interpret the results. The recommended cholesterol and triglyceride levels for you will depend on your risk factors for a heart attack, including lifestyle, medical and hereditary factors.
  3. When A cholesterol test should occur once every five years beginning at age 18. Men over age 45, women over age 55 and those with certain risk factors may require more frequent screening.
  4. Where Your doctor will coordinate all of your blood tests with you.
  5. TRICARE benefit information

Physical Exam

  1. Why The physical examination is used to monitor your overall health. It helps physicians screen for diseases and assess your risk for future health problems.
  2. What A physical exam is the examination of a patient for outward signs of illness or disease. Your doctor will thoroughly examine you by talking, touching and listening. Part of the exam will be your doctor asking for your medical history, such as any diseases or illnesses you may have had and any current medications you are taking. You should also give your provider a family medical history including any illnesses of your close relatives (parents, siblings or other family members). The physical portion of the exam covers your height, weight, temperature, heart rate and blood pressure. The doctor will also listen to your lungs for evidence of fluid, examine the curvature of your spine and check your joints for inflammation or tenderness. Blood or urine samples may also be collected for analysis.
  3. When You should discuss a regular exam schedule with your doctor, taking into account your health condition, lifestyle and family health history.
  4. Where Your doctor or health care provider may include a physical exam during your regular wellness visit.
  5. TRICARE benefit information

Skin Cancer Screening & Self-exam

  1. Why Skin cancer is the most common form of cancer to occur in both women and men. By visually inspecting any new, misshapen or discolored moles or lesions you can catch potential cancerous growths early enough for treatment.
  2. What A skin cancer screening is an exam in which a doctor visually inspects your skin for signs of skin cancer. You can perform a self-exam by examining your skin in a mirror, noting any suspicious moles or other skin abnormalities. Your doctor will examine your skin, paying particular attention to areas that receive the most sun exposure. Your scalp will also be examined and may require parting or moving your hair. Any suspicious growths may be either fully or partially removed by your doctor for further examination. Usually the area will be numbed with a local anesthetic. To help recognize potential problems, the American Cancer Society encourages periodic self-examinations, making sure you watch for growths meeting one of the following 'ABCDs' of melanoma:

    • Asymmetry: One half of the growth doesn't match the other half.
    • Border irregularity: The edges of the growth are ragged, notched, or blurred.
    • Color: The growth is not uniformly covered.
    • Diameter: Any growth greater than six millimeters (about the size of a pencil eraser) is cause for concern.
  3. When You will want to discuss an optimal screening schedule with your doctor. Your schedule should depend on your sun exposure and family cancer history. It is important to have regular screenings because your doctor will note any changes in the size, shape, color or condition from one visit to the next. Changes to your moles may be a sign of cancer.
  4. Where Your doctor can perform a skin cancer screening during your routine physical exam. A dermatologist can also check your body for signs of skin cancer. You should perform your self-exam in front of a large mirror where you will also have access to a hand-held mirror for hard-to-view areas.
  5. TRICARE benefit information

Colonoscopy

  1. Why Colonoscopy is used as a screening test to check for cancer or precancerous growths in the colon or rectum. Your doctor may also prescribe a colonoscopy to check on the cause of chronic diarrhea or bleeding inside the colon.
  2. What During a colonoscopy, your doctor will use a thin, flexible tube called a colonoscope to look at the inner lining of your large intestine, including the colon. A colonoscopy helps find ulcers, polyps, tumors, and areas of inflammation or bleeding. During a colonoscopy, tissue samples can be collected to be examined later and any abnormal growths may be removed. There is usually a mild sedation administered and the test can take from 30 minutes to an hour. Your doctor will recommend a specific program for you to follow to prepare for the test. You might be put on a clear liquid diet for one or two days prior to your test. Plan to stay home during your preparation period; the preparation program causes loose, frequent stools and diarrhea so that your colon will be empty for the test.
  3. When If you have a hereditary risk of colon cancer, you may be considered high-risk and should discuss with your doctor about starting the colonoscopy screening early. For those with an average risk of colon cancer, you should have a colonoscopy once every 10 years after turning 50.
  4. Where Your doctor will schedule your colonoscopy and tell you what to do the day or night before in preparation.
  5. TRICARE benefit information
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