Does TRICARE cover orthotics?
Quick Answer
Yes, TRICARE covers medically necessary custom orthotics including foot orthotics, braces, and splints when prescribed for diagnosed conditions. Over-the-counter insoles are not covered.
Detailed Answer
TRICARE covers orthotic devices when they are medically necessary and prescribed by a TRICARE-authorized provider. Covered orthotics include custom foot orthoses for conditions like plantar fasciitis or diabetic neuropathy, ankle-foot orthoses (AFOs), knee braces for ligament injuries, spinal orthoses for back conditions, and wrist and hand splints for carpal tunnel syndrome or fractures. The orthotic must be prescribed for a specific diagnosed medical condition and fitted by an authorized orthotist or provider. TRICARE may require pre-authorization for certain custom orthotic devices, and replacement orthotics are covered when the existing device is worn out or no longer fits due to a change in the patient's condition. Over-the-counter shoe insoles and non-prescription comfort devices are not covered. Standard copays and cost-shares apply, and using a network orthotics provider will result in lower out-of-pocket costs.
Related TRICARE Terms
Related Questions
Does TRICARE cover prosthetics?
Yes, TRICARE covers prosthetic devices including artificial limbs, breast prostheses after mastectomy, and other prosthetic appliances when medically necessary.
Does TRICARE cover durable medical equipment?
Yes, TRICARE covers durable medical equipment (DME) such as wheelchairs, CPAP machines, hospital beds, and oxygen equipment when medically necessary and prescribed by a provider.