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coverage
Does TRICARE cover second opinions?
Verified by TRICARE.com Editorial Team
Updated 2024-12-01
AI-assisted (gemini)
Quick Answer
TRICARE covers second medical opinions for diagnoses and treatment plans. You may need a referral (Prime) and should use network providers.
Key Takeaways
- Covered benefit
- Referral needed (Prime)
- Standard costs apply
- Your choice which to follow
Detailed Answer
Second opinions are a covered benefit.
When Covered
- Diagnosis questions
- Treatment plan uncertainty
- Surgery recommendations
- Complex conditions
How to Get
- Prime: Referral from PCM
- Select: Direct access
- Network provider preferred
- Document request
Cost
- Standard cost shares
- Same as specialist visit
- Network vs non-network applies
- Counts as office visit
What to Bring
- Medical records
- Test results
- Previous treatment info
- Questions prepared
Using Your Second Opinion
- Your choice of treatment
- Can go with either doctor
- Discuss with original provider
- Document in your records