Table 1: Comparison of TRICARE Pap Smear and Mammogram Standards With ACOG Guidelines

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Foundation Health Plan of the Mid-Atlantic States, Inc. (Kaiser), one of the
FEHBP's largest HMO plans. Specifically, BlueCross BlueShield and Kaiser
also offer the full range of women's health care services covered by
TRICARE as listed above, including obstetrical and gynecological care,
maternity care, family planning, mammography, reconstructive breast
surgery, hormone therapy, and bone density studies. For example,
TRICARE coverage for Pap smears and mammograms is in line with the
FEHBP plans that we reviewed as well as with ACOG guidelines that call
for screenings based on age and risk. (See table 1.)
Table 1: Comparison of TRICARE Pap Smear and Mammogram Standards With ACOG Guidelines and Other Plan Standards
FEHBP Fee-for-service
(BlueCross BlueShield)
Pap smear
Preventive care includes a
Preventive care includes a
Preventive care includes a routine
Preventive care includes a
routine Pap smear. Regarding
routine Pap smear
Pap smear annually when sexually
routine Pap smear annually at
test frequency, members are
annually for women of any age.
active or at age 18. For patients
age 18 (or younger, if sexually
advised to consult with
age 19 and above, physician and
active) until three normal tests.
physician to determine what is
patient discretion is recommended
After three normal tests, then
after three consecutive normal
test frequency is a physician
tests, if low risk.a
and patient decision, but not
less than every three years.
Preventive care includes a
Preventive care includes a routine  Preventive care includes a
Preventive care includes a
routine mammogram for women
mammogram for women as follows: routine mammogram for women
routine mammogram for
as follows:
women as follows:
as follows:
Age 19 to 39: periodic
assessment, if high riskb
Age 35 to 39: 1 baseline test
Age 35 to 39: 1 baseline test
Age 40 and below: 1 baseline
Age 40 to 64: 1 test annually
Age 40 to 64: 1 test every
Age 40 to 49: 1 test every 1 to 2
Age 65 and above: 1 test
calendar year
Age 41 to 50: 1 test every 2
every 2 consecutive calendar
Age 65 and above: 1 test
Age 50 to 64: yearly
every 2 consecutive calendar
Age 50 and above: yearly.
Age 65 and above: periodic
ACOG recommends more frequent Pap tests when one or more high risk factors is present,
for example, women who have had multiple sexual partners and women with a history of
sexually transmitted diseases.
For mammograms, high risk is defined as women who have had breast cancer or have a
first-degree relative (that is, mother, sister, or daughter) or multiple other relatives who have
a history of premenopausal breast, or breast and ovarian, cancer.
Sources: ACOG guidelines effective in 2002, DOD TRICARE benefit for 2002, Kaiser
Foundation Health Plan of the Mid-Atlantic States, Inc. for 2002, and BlueCross BlueShield
Service Benefit Plans for 2002.
Page 8
GAO-02-602 DOD's Women's Health Care

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