TRICARE Undersea Medicine & HBOT Coverage Guide (2026)

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## Quick answer TRICARE covers Undersea Medicine (specifically Hyperbaric Oxygen Therapy or HBOT) when it is medically necessary to treat specific conditions like decompression sickness, severe carbon monoxide poisoning, or non-healing diabetic wounds. While routine wellness or experimental underwater "anti-aging" treatments are excluded, TRICARE covers these services at an authorized hospital or clinic when prescribed by a physician and authorized by your regional contractor (Humana Military or TriWest).

## In detail Undersea Medicine in the TRICARE context primarily refers to **Hyperbaric Oxygen Therapy (HBOT)**. This involves breathing 100% oxygen while in a pressurized chamber. Because this treatment is specialized and high-cost, coverage is strictly limited to FDA-approved and clinically proven applications.

### Covered Conditions (2026 Policy) TRICARE currently covers HBOT for the following diagnoses: * **Decompression Sickness:** Often referred to as "the bends," typically involving divers. * **Gas Embolism:** Air bubbles in the bloodstream. * **Carbon Monoxide Poisoning:** Specifically acute cases or those complicated by cyanide poisoning. * **Gas Gangrene:** Life-threatening soft tissue infections. * **Crush Injuries:** Acute traumatic peripheral ischemia where blood flow is severely restricted. * **Progressive Necrotizing Infections:** Flesh-eating bacteria scenarios. * **Osteoradionecrosis:** Bone damage caused by radiation therapy. * **Diabetic Wounds:** Specifically "Wound Care of the Lower Extremities" (Type 1 or Type 2 diabetes) when the wound is a Grade III or higher and has failed to respond to at least 30 days of standard wound management.

### Exclusions and Limitations TRICARE specifically **excludes** Undersea Medicine/HBOT for conditions where clinical efficacy has not been proven, including: * Autism or cerebral palsy. * Multiple Sclerosis (MS). * Traumatic Brain Injury (TBI) or stroke (unless part of a specific authorized clinical trial). * Migraines or chronic fatigue syndrome.

### Cost-Shares and Authorizations (2026 Rates) Because HBOT is often administered in an outpatient hospital setting, your costs depend on your plan:

*Note: Pre-authorization is almost always required for HBOT unless it is an emergency (e.g., immediate decompression sickness).*

## Who this applies to * **Active Duty Service Members (ADSMs):** Full coverage for job-related dive injuries or approved medical conditions at military or civilian facilities. * **Military Divers and Submariners:** Primary beneficiaries for undersea-specific occupational medicine. * **Retirees with Chronic Conditions:** Specifically those with non-healing diabetic foot ulcers or radiation-induced tissue damage. * **Beneficiaries in the West Region:** Now managed by **TriWest Healthcare Alliance** (as of Jan 1, 2025); they handle all undersea medicine authorizations for the Western US. * **Beneficiaries in the East Region:** Managed by **Humana Military**.

Common scenarios

### Scenario 1: The Recreational Dive Accident An Active Duty family member on TRICARE Select suffers decompression sickness after a civilian scuba trip in Florida. They are rushed to a hospital for emergency HBOT. Because it is an emergency, pre-authorization is waived for the initial "dive." Following the deductible, the family pays a 20% or 25% cost-share (2026 Group A/B rates) for the outpatient hospital services.

### Scenario 2: Chronic Diabetic Wound Care A retired veteran (Group A) has a severe diabetic foot ulcer that hasn't healed in 45 days. Their doctor requests 20 sessions of HBOT. They use **TRICARE Prime**. TriWest (West Region) authorizes the treatment. The veteran pays a $38 copay per session (2026 rate) at a civilian wound care center.

### Scenario 3: Radiation Damage A beneficiary treated for jaw cancer develops bone necrosis (osteoradionecrosis) three years later. TRICARE covers Undersea Medicine/HBOT as a standard treatment to stimulate bone healing. Under **TRICARE Select**, the beneficiary pays their annual deductible and then a percentage of the allowable charge.

## Related terms * **HBOT:** Hyperbaric Oxygen Therapy; the primary treatment method in Undersea Medicine. * **DHA:** Defense Health Agency; the body that sets the policy for what undersea treatments are covered. * **Decompression Sickness:** Illness caused by nitrogen bubbles forming in the body after a rapid decrease in pressure. * **T-5 Contract:** The current TRICARE contract (effective 2025) which transitioned the West Region to TriWest Healthcare Alliance. * **Wound Care:** A multi-disciplinary medical field that often utilizes HBOT for non-healing ulcers.

## Sources * TRICARE.mil - Hyperbaric Oxygen Therapy: https://www.tricare.mil/CoveredServices/IsItCovered/HyperbaricOxygenTherapy * Defense Health Agency (DHA) Policy Manual: https://manuals.health.mil/ * TriWest Healthcare Alliance (West Region): https://www.triwest.com/ * Humana Military (East Region): https://www.humanamilitary.com/