Back to All FAQs
coverage
Does TRICARE cover surgery?
Verified by TRICARE.com Editorial Team
Updated 2024-12-01
AI-assisted (gemini, gpt-4o)
Quick Answer
TRICARE covers medically necessary surgery including emergency, outpatient, and inpatient procedures. Cost-shares depend on plan type. Referrals required for Prime.
Related Video
Key Takeaways
- Medically necessary surgery covered
- Active duty has no cost
- Authorization may be required
- Cosmetic surgery excluded
Detailed Answer
TRICARE provides comprehensive surgical coverage:
What's Covered
- Medically necessary surgeries
- Emergency surgeries
- Outpatient/ambulatory surgery
- Inpatient hospital surgery
- Anesthesia services
- Post-operative care
Examples of Covered Surgeries
- Appendectomy, gallbladder removal
- Hernia repair
- Joint replacement
- Cancer surgeries
- Cardiac procedures
- Emergency trauma surgery
Cost Considerations
- Active duty: No cost
- Prime: Lower cost-shares, MTF priority
- Select: Higher cost-shares
Authorization Requirements
- Prime: Referral from PCM required
- Select: No referral but prior authorization for some
- Some procedures need pre-approval
Elective vs Emergency
- Emergency surgery covered immediately
- Elective procedures may need authorization
- Cosmetic surgery generally not covered
What's NOT Covered
- Purely cosmetic surgery
- Experimental procedures (usually)
- Weight loss surgery (limited)
Helpful Tips
- Get referral before elective surgery
- Verify authorization requirements
- Understand your cost-shares
Sponsored
What do most military families add to their TRICARE coverage?
Most Popular
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
See What's AvailableShare this page
Was this FAQ helpful?
Need personalized help with this?
Most military families leave benefits on the table. Our free 2-minute coverage check identifies gaps, finds potential savings, and gives you personalized recommendations.
Check My Coverage 100% Free Instant Results No Signup Required