Last Updated on May 12, 2023
The question comes up regularly on military message boards, and the debate soon ensues.
Does the Army (or military) pay for dependents to have plastic surgery for cosmetic purposes?
The Infamous Pilot Program
It seems everyone had heard of the pilot program from a few years ago, where some dependents were given the option to have cosmetic procedures when they paid for some portion of the surgery (such as the implants).
Army physicians performed the surgery relatively cheaply compared to civilian plastic surgeons. But it wasn’t as widespread as some people believe.
Beverly was kind enough to post the Army’s position on cosmetic procedures on the message board, and I thought I would share it with all of you.
Please note that this is regarding STRICTLY cosmetic procedures. If there is a medical reason for the surgery, Tricare may cover all or part of the costs. Of course, that is determined on a case-by-case basis.
The Official Word on Plastic Surgery
Regardless, here is the official stance from the U.S. Army Surgeon General’s Office:
Recruiters must know the facts and present the truth when faced with questions regarding the Army’s medical Benefits for cosmetic surgery.
According to the Army Surgeon General’s office, “If a person joins the military in hopes of receiving cosmetic surgery, they will almost certainly be disappointed because of the minimal number of cases performed. Military medicine is not in the makeover business.”
Benefits under Tricare do NOT cover cosmetic surgery procedures. The Army does have plastic surgeons.
Because the skills used in performing cosmetic surgery procedures are often the same skills required in obtaining optimal results in reconstructive surgery, these surgeons have a valid need to perform cosmetic surgery cases to maintain their specialty surgical skills.
They also need to meet board certification, recertification, and graduate medical education program requirements for specialties requiring training in cosmetic surgery.
However, Army plastic surgeons prioritize taking care of injured Soldiers. Plastic surgery is an integral part of training for battlefield medicine.
Therefore, Army surgeons focus on reconstructive plastic surgery–such as repairing cleft palates and reconstructive surgery for patients with mastectomies.
Surgeons perform a limited amount of cosmetic surgeries on a time and space-available basis. Patients pay some of the costs for these surgeries (i.e., mastectomy patients pay for their implants), and insurance is collected when possible.
Family members who receive cosmetic surgery pay fees for the procedure and any implants.
All patients, including Active Duty soldiers, undergoing cosmetic surgery procedures must pay the surgical fee, plus any applicable institutional and anesthesia fee, for the procedures following the fee schedule published annually by the Office of the Secretary of Defense Comptroller.
How can a woman that has only been married to a military guy for 15 months be eligible for the breast implants?? I know for a fact she is having this procedure done in Miami in 2 weeks.. Why would our tax dollars be paying for such a thing???
It is my understanding that Tricare will not approve implants for purely cosmetic reasons. However, how long she has been married to a soldier would have no bearing on her insurance coverage. She is covered from the first day of marriage.
I you would have read above!!!!!!!!! the skills used in performing the cosmetic surgery procedures are often the same skills required in obtaining optimal results in reconstructive surgery, these surgeons have a valid need to perform cosmetic surgery cases to maintain their specialty surgical skills. They also need to meet board certification, recertification, and graduate medical education program requirements for specialties requiring training in cosmetic surgery.
My husband has 8 yrs in and is going to Afghanistan in Oct….I hope he never gets hurt but if he does I hope the Dr has some experience….
Also we pay taxes as well.!!!!
I actually had breast reduction surgery via Tricare Prime and paid no out-of-pocket, but there is a lot of debate (depending on the person you talk to outside of the medical community) whether that counts as more asthetic or medically necessary. For me, it was a relief after a lifetime of having a small frame and ridiculously large chest to not have continual back and should pain, although after the surgery to an outsider it looks more “cosmetic”. I had wanted it done since I was 22 but was unable to afford even the partial pay with civilian insurance coverage, but finally at age 40 I was able to have it done thanks to my husband’s Army benefits.
Can you tell me how long it took after you saw a plastic surgeon for Tricare to approve it?
About 2 weeks.
Having spent twenty-five years in private practice before entering active duty where I currently serve as Chief of Plastic Surgery at an Army Med Center, I feel qualified to answer your question(s). Breast reduction surgery was considered a “gray area” for years with many insurance companies arguing it was cosmecti regardless of how symptomatic the patient might be with neck, back and shoulder pain, skin rashes, etc. That is not the case today. Breast reduction surgery is considered a coded procedure eligible for insurance compensation if it meets certain standards concerning severity of symptoms, failure of conservative treatment (weight loss, physical therapy, use of anti-inflammatory meds, etc.) and a reasonable amount of tissue is removed relative to the patient’s height/weight. TriCare is more conservative than most third party payers (at least in our area), but this is important only if you are seeking care in the private sector (“out of network”). If you are willing to wait–sometimes for an extended period–to work your way up the waiting list, you can have this done at any AMC that offers plastic surgery services without obtaining TriCare precertification. Your surgeon will discuss the type of procedure being done, expected result, morbidity and complications. Expect to wait anywhere from a few months to up to two years to receive a surgery date.
Thank you so much for taking the time to reply!
so who do you contact to get this done? im also tricare prime..
Your PCM.
Tricare does not cover plastic surgery. However, some procedures that are considered medically necessary like:
Breast reductions (you need to show a significant need, like infections, and extreme gouging to the shoulders from weight, curvature of the spine… etc…
Panictillectomy (if you get constant infections that can not be cured by normal topical ointments or prevented by using antiperspirant- it proves to be a real health risk then that sort of procedure may be considered medically necessary)
Botox (believe it or not botox paralizes muscles and is great if you have neck pain… and the 5 shots in the neck still get you 2 free shots in the face… catch my drift)
nose jobs (if you have issues with breathing because of the shape of your nose, or you were injured while on duty, the military pays to fix it.
Eye lifts(Only if the droop on the eye is so bad it impedes on your vision)
GASTRIC BYPASS (you need to be at min 90lbs over weight, you need to show you are both physically, mentally, and emotionally ready for this procedure)
Most bases do not have plastic surgeons, how ever if your base happens to have one that is not working in the field putting soldiers back together, you might be able to get an appointment at the base but medical necessity would still need to be there. MTF’s can really choose what they do with their funding for medical… Just be aware that if you are planning on getting a surgery that might be considering questionable, just visit your PCM, RULE OUT ALL OPTIONS of treatment first…. DOCUMENT IT ALL… When you request your authorization be prepared you need to make sure your doctor and the facility, are approved and accept your coverage. I hope this helps clear up a few things…
Okay here is my question will tricare pay for a breast lift ? if so how long does it take and who do you talk to the doctor besides the ones at sfmc ?
Tricare MAY pay for medically necessary plastic surgeries. They often will NOT pay for ones for cosmetic reasons so it really depends on the reason for the surgery.
I have a question. i have had two kids via c section n have loose skin. I want a tummy tuck to fix my loose skin problem, so how do i go about getting info n finding out if i can get it thru the army. ive been hearing that i can get one plastic surgery for free every enlistment. im a army wife.
Tricare generally only pays for plastic surgery when it is medically necessary. You would have to call Tricare for further clarification on what can be covered.
http://www.tricareonline.com has everything listed that they cover including physicians in the network.
Okay I have a question, I have tricare prime, I have to get surgery on my nose already to fix my sinuses and a very crooked nose. All of this is already covered, but will they also pay to have the lump on my nose shaved off, this I’m not sure is medically necessary…
But you can now get surgery to change yourself from a boy to girl or vice versa, hooray!