Question:
Anyone get approved by Tricare for PS?

I am looking into having some plastic surgery done and am curious as to if or not I have any chance of getting tricare to pay for anything. I am looking into a breast lift/reduction (they say that's how it will have to be worded) and a tummy tuck. I am also overseas so I am wondering if this will pose a problem for them as well. Thanks for any answers/advice I get !!    — cedsangel (posted on November 8, 2005)

November 8, 2005
Good luck! I have not heard of anyone getting them to pay for any plastic surgery. The TricarePrime plan only covers if you have had breast cancer or a deformity.
   — Sweet Pea

November 8, 2005
You need to go to the Plastic Surgery Message Board and research older post, this has been covered over and over again. That said, I have Tricare Prime, and I have had a breast reduction - and a panni w/hernia repair paid by Tricare Prime 100%. They do not do breast lifts or abdoplastony surgery. Call the Tricare office or look at your handbook, and find the list of surgeons, be pro-active and call each surgeon and find out what there surgery skills are, then go to your pcp and tell him the name of the surgeon of Tricare Primes network surgeons and your pcp will submit to Tricare for a consultation and evalation, when you go for your consultation, you need to have documentaion of rashes, pictures of rashes or indentations in the shoulder from the weight of your breast, letters from chiropactors or doctors saying your surgeries are medically necessary. Tricare Prime surgeons will submit the paperwork and the medical necessary documentation to for you. I also included a letter stating that all the excess hanging skin was keeping me from normal functions, like excercise and maratial relations. I listed all of my pains, and I also had my pcp write a script for rash cream and took a copy of the script and gave that to Tricare Prime. Your first step should be to call Tricare Prime and get a list of surgeons to research, and the second step would be to go to your pcp and present your documentation, your pcp does not determine if you need ps or not, your pcp only submits for a consultation, the ps will tell you what you need completed for a normal function of life.
   — cindy

November 15, 2005
Go to your insurance company's website or call them and ask for their clinical guidelines. Then you will know what you have to do and if there is a chance. Unfortunately, most insurance companies will pay only for a pannilectomy if you are having back pain and a problem with rashes, but not for a tummy tuck or other plastic surgery, because they consider it elective. Funny, they pay for it for women who had breast cancer!!!!
   — Novashannon

November 16, 2005
I have TricarePrime and they will pay for the Tummy Tuck only after a year of the Gastric Bypass. But you also have to have the excess skin. Hope this helps. As for the Boob job, You could prob get them to pay for it if you have rashes that are noted in your med. records. or they are giving you back problems.
   — Stephanie_whatley

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