I was wondering if tricare prime covers a surgery to fix this issue?

Question

I have very uneven breasts. One being a DDD and the other a B.

Nelson Castillo, MD · Answer

Thank you for your question.  In general insurance companies do not view corrective surgery for breast asymmetries, even large ones, as medically necessary and will not cover the procedure.  That said, if your larger implant is causing you significant issues from a neck/back pain point of view, or with rashes, skin breakdown, or infections, you may be able to qualify for a breast reduction.  Best to call your carrier and see what procedures they cover and the criteria for approval.  Hope this helps.

Nicholas Tarola, MD · Answer

Thank you for your question.  Insurance companies usually do not cover correction of breast asymmetries, especially when the patient is not having any symptoms related to the issue.  However, if the larger breast is causing a problem such as pain (neck, back, shoulder) or rashes, insurance may cover reduction of that side.  Consider consulting with a board certified plastic surgeon for an evaluation and for more information.  Best wishes!

Susan MacLennan, MD · Answer

HelloI would recommend scheduling a consultation with an experienced plastic surgeon in your area who takes TriCare. It has been my experience that TriCare will often cover breast reductions, but you will need to be seen in person and your surgeon will need to request prior authorization from TriCare before you will know for sure. You may also want to call TriCare so you understand their policy on breast surgery. Be sure to find a surgeon who is a TriCare provider, as many surgeons do not take TriCare.Best wishes-

Kiran Polavarapu, MD · Answer

In my experience, most insurances view breast asymmetry a cosmetic issue and may not cover if there is no underlying pathology (cancer, tumors, wounds, intractable pain etc). The only way of knowing is to either seek consultation from a plastic surgeon that takes Tricare for consultation of your concerns and to also call Tricare and ask them about coverage. Good Luck!

Brian Widenhouse, MD · Answer

Thanks for your question. Generally, insurance companies (including Tricare) do not cover breast surgery to correct symmetry. You may qualify to have a breast reduction on your larger breast covered by Tricare, if you meet the criteria. I suggest you make an appointment with a PS in your area who is a Tricare provider and explore your options. You will need to obtain referral from Tricare for that appointment.Good luck!

I was wondering if tricare prime covers a surgery to fix this issue?

Answers (6)

Answer: Tricare coverage

Answer: Tricare coverage

Answer: Tricare coverage for breast asymmetry

Answer: Tricare coverage for breast asymmetry

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.

I was wondering if tricare prime covers a surgery to fix this issue?

Answers (6)

Answer: Tricare coverage

Answer: Tricare coverage

Answer: Tricare coverage for breast asymmetry

Answer: Tricare coverage for breast asymmetry

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.