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


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?

Doctor Answers 8

August 2nd, 2014

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

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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!
Lewis Albert Andres, MD
February 2nd, 2014

Insurance not for cosmetic procedures

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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.
Michael Burgdorf, MD, MPH
January 27th, 2014

Breast Enhancement Surgery

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I cant imagine any insurance company covering a purely aesthetic surgery regardless of where you are, that being said it cant hurt to try
Ryan Neinstein, MD, FRCSC
January 24th, 2014

BBA

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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!

Learn more: http://www.drpirani.com/breast-enhancement-toronto/breast-augmentation/

Asif Pirani, MD, FRCS(C)
January 24th, 2014

?coverage for breast aug/lift and tummy tuck?

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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. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

January 24th, 2014

Insurance companies differ in coverage.

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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.
Richard H. Fryer, MD
January 24th, 2014

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

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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. 
James E. Murphy, MD, FACS
January 24th, 2014

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

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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.

Learn more: http://www.poustiplasticsurgery.com/Procedures/Procedure_breastAugmentation.htm

Tom J. Pousti, MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.