Will Tricare cover any of my procedures or medication for plastic surgery?

Question

Hello I am in Germany,in the US Military and looking for a doctor to perform a Breast Lift with Implants and a Tummy Tuck. How would tricare play in this? Do they cover the medication if I take it to the base pharmacy? Does anyone know if Tricare covers anything pertaining to these procedures?

Ryan Neinstein, MD, FRCSC · Answer

I cant imagine any insurance company covering a purely aesthetic surgery regardless of where you are, that being said it cant hurt to try

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! Surgical procedures for aesthetic 
purposes, to improve appearance, are not covered by insurance. 
Typically, these as well as complications resulting from such procedures
 are the responsibility of the patient. Procedures that are meant to 
correct functional issues and those which cause health-related issues 
should be covered by your insurance as a medical necessity, with proper 
examination and documentation.  Some insurance plans have exclusion 
criteria for certain procedures.  Also, it is an obligation of the 
surgeon not to attempt to authorize purely cosmetic procedures through 
insurance.  Discuss your issues and 
complaints with a board-certified plastic surgeon to discuss these as 
well as to examine and assist you in deciding which procedure(s) will be
 the best for you. A discussion of the advantages and disadvantages will
 take place along with the risks and benefits. Insurance companies will 
vary on coverage and is always reasonable to discuss your issues with 
your surgeon and primary care. It would behoove you to get as much 
information as possible and even call your insurance yourself. 
Certainly, pay in advance prior to your surgical procedure and options 
such as financing are available if you qualify. Hope that this helps! 
 Best wishes!

Michael Burgdorf, MD, MPH · Answer

Unfortunately, insurance does not cover elective cosmetic procedures.  Medication coverage typically depends on your insurance plan, with regards to your deductible, total vs partial coverage,etc. check with them about medication coverage specifics.

Asif Pirani, MD, FRCS(C) · Answer

I think it would be highly unlikely, but I don't live or work in Germany.  You should call Tricare and ask them.  They are the only ones that can tell you for sure.  Good luck!

Richard H. Fryer, MD · Answer

Most insurance companies include a list of "uncovered conditions or procedures" to inform policy holders of what options they may have.  I have found that Tricare is often more lenient than other insurance providers about some of the covered procedures because of specific uniform and physical requirements that they have on military personnel. The best thing to do is see your surgeon and ask them to pre-authorize your procedure.Good luck.

James E. Murphy, MD, FACS · Answer

The short answer is "No".  Insurance will not cover any procedures which are deemed cosmetic in nature or not "medically necessary".  In some cases the medication will be covered as they normally do not ask for a diagnosis code for medications covered by your insurance.

Jourdan Gottlieb, MD · Answer

It would be extremely unusual to have coverage for these procedures by Tricare, or by any other carriers. As to medications, more and more, but not all,  insurers ask for a diagnosis for medications, and if a correct diagnosis is given, chances are the medications would not be covered. All the best.

Tom J. Pousti, MD · Answer

It is not unusual for prescriptions to be covered by health insurance companies; however, for accurate information, best to check with your local pharmacy. Best wishes.

Will Tricare cover any of my procedures or medication for plastic surgery?

Answers (8)

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