Does TRICARE cover dermatology and skin conditions?
Quick Answer
TRICARE covers dermatology for medical skin conditions including acne, eczema, psoriasis, skin cancer screening, and biopsies. Cosmetic procedures are excluded. Prime requires a PCM referral to a dermatologist.
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Key Takeaways
- Medical dermatology conditions are fully covered by TRICARE
- Cosmetic procedures are excluded from coverage
- Skin cancer screening is covered as preventive care at no cost
- Prime requires a referral; Select allows direct access to dermatologists
Detailed Answer
TRICARE covers dermatological care for medical conditions but excludes cosmetic procedures that are performed solely for appearance.
Covered Dermatology Services
- Skin cancer screening and biopsy
- Treatment of acne, eczema, psoriasis, and rosacea
- Skin infection treatment (fungal, bacterial, viral)
- Wart and lesion removal when medically necessary
- Dermatitis and allergic skin reactions
- Wound care and burn treatment
- Skin allergy patch testing
Skin Cancer Coverage
- Annual skin cancer screenings (preventive)
- Biopsy of suspicious moles and lesions
- Surgical removal of skin cancers (Mohs surgery covered)
- Radiation and other cancer treatments
- Follow-up monitoring and care
Cosmetic Procedures NOT Covered
- Elective mole removal for cosmetic reasons
- Chemical peels for appearance enhancement
- Botox for cosmetic purposes (covered for certain medical conditions like migraines)
- Laser skin resurfacing for wrinkles
- Cosmetic tattoo removal
- Hair removal for cosmetic reasons
- Scar revision unless functionally necessary
Referral Requirements
- TRICARE Prime: PCM referral required to see a dermatologist
- TRICARE Select: No referral needed, direct access to network dermatologists
- MTF dermatology clinics available but may have long wait times
- Urgent skin conditions may be seen without referral
Costs
- Preventive skin screening: $0 (covered as preventive care)
- Active duty: No cost
- Active duty families (Prime): Low or no copay
- Retirees: Standard specialist copay or cost-share
- Biopsies and procedures: Standard outpatient copays
Common Dermatology Referral Reasons
- Persistent acne not responding to primary care treatment
- Suspicious moles or changing skin lesions
- Chronic skin conditions requiring specialist management
- Pre-cancerous skin growths (actinic keratoses)
- Severe eczema or psoriasis flares
Tips for Dermatology Care
- Use sunscreen daily to prevent skin cancer and sun damage
- Document changes in moles with photos for your provider
- Ask your PCM about skin cancer screening during annual wellness visits
- Request a dermatology referral early if you have a family history of skin cancer
Helpful Tips
- Request a skin cancer screening during your annual wellness visit
- Take photos of any changing moles to share with your dermatologist
- If your MTF has long dermatology wait times, ask your PCM for a civilian referral
Related TRICARE Terms
Related Questions
What services does TRICARE cover?
TRICARE covers preventive care, doctor visits, hospitalization, surgery, mental health, maternity, prescriptions, and more with some requiring authorization.
What does TRICARE NOT cover?
TRICARE does not cover cosmetic surgery, experimental treatments, custodial care, most dental (unless separate plan), or services from non-authorized providers.
What preventive care does TRICARE cover?
TRICARE covers annual physicals, immunizations, cancer screenings, well-child visits, and other preventive services at no cost with network providers.
What do most military families add to their TRICARE coverage?
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.
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