{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:49:44Z","timestamp":1780649384256,"version":"3.54.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Why Defense Health Horizons Performed This Study<\/jats:title>\n                  <jats:p>The primary role of the Military Health System is to assure readiness by protecting the health of the force by providing expert care to wounded, ill, and injured service members. In addition to this mission, the Military Health System (both directly through its own personnel and indirectly, through TRICARE) provides health services to millions of military family members, retirees, and their dependents. Women\u2019s preventive health services are an important part of comprehensive health care to reduce rates of disease and premature death and were included in the 2010 Patient Protection and Affordable Care Act\u2019s (ACA) expanded coverage of women\u2019s preventive health services, based on the best available evidence and guidelines. These guidelines were updated by the Health Resources and Services Administrations and the American College of Obstetrics and Gynecology in 2016. However, TRICARE is not subject to the ACA, and therefore, TRICARE\u2019s provisions or the access of TRICARE\u2019s female beneficiaries to women\u2019s preventive health services was not directly changed by the ACA. This report compares women\u2019s reproductive health care coverage under TRICARE with coverage available to women enrolled in civilian health insurance plans subject to the 2010 ACA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>What Defense Health Horizons Recommends<\/jats:title>\n                  <jats:p>Three recommendations are proposed to ensure that women who are TRICARE beneficiaries have access to and receive preventive reproductive health services that are consistent with Health Resources and Services Administration recommendations as implemented in the ACA. Each recommendation has strengths and weaknesses that are described in detail in the body of this paper.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>What Defense Health Horizons Found<\/jats:title>\n                  <jats:p>In covering contraceptive drugs and devices, TRICARE appears to reflect the scope of coverage found in ACA-compliant plans but, by not incorporating the term \u201call FDA-approved methods\u201d of contraception, TRICARE leaves open the possibility that a narrower definition could be adopted at a future date. There are important differences in how TRICARE and ACA-compliant plans address reproductive counseling and health screening, including TRICARE\u2019s more restrictive counseling benefit and some limits to preventive screening. By not aligning with policies related to the provision of clinical preventive services established under the ACA, TRICARE allows health care providers in purchased care to diverge from evidence-based guidelines. Although the ACA respects medical judgment when providing women\u2019s preventive services, standards restrict the extent to which health care systems and providers can depart from evidence-based screening and prevention guidelines essential to optimizing quality, cost, and patient outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usac224","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T23:48:08Z","timestamp":1678232888000},"page":"24-30","source":"Crossref","is-referenced-by-count":1,"title":["Assuring TRICARE Coverage of Preventive Health Services for Women Beneficiaries of the Military Health System"],"prefix":"10.1093","volume":"188","author":[{"given":"Elizabeth A","family":"Kostas-Polston","sequence":"first","affiliation":[{"name":"Daniel K. Inouye Graduate School of Nursing, Uniformed Services University , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine T","family":"Witkop","sequence":"additional","affiliation":[{"name":"F. Edward Hebert School of Medicine, Uniformed Services University , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda C","family":"Degutis","sequence":"additional","affiliation":[{"name":"Yale School of Public Health , New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University , Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan F","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Jacobs Institute of Women\u2019s Health, Milken Institute School of Public Health, George Washington University , Washington, DC 20052, 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