Does TRICARE cover breast reduction?

TRICARE covers breast reduction surgery (reduction mammaplasty) when it meets medical necessity criteria and is not performed solely for cosmetic purposes. To qualify for coverage, the beneficiary must have documented symptoms of macromastia including chronic back, neck, or shoulder pain, skin rashes or infections in the breast fold, bra strap grooving, or nerve damage. The referring provider must document that conservative treatments such as physical therapy, supportive undergarments, and pain management have been tried and failed to provide adequate relief. Pre-authorization from TRICARE is required before the procedure, and a minimum amount of tissue removal is typically specified in the medical policy. The surgery must be performed by a TRICARE-authorized surgeon, and standard copays and cost-shares apply based on the beneficiary's plan. Post-operative care and follow-up visits are covered as part of the surgical benefit.