TRICARE FAQs: COVID-19 and Resuming Elective Procedures

6/15/2020

As you begin to adjust to the new normal, you may have questions about your TRICARE benefit. You can find answers to your frequently asked questions (FAQs) and more on the TRICARE Coronavirus FAQs page.

The following are some of the most frequently asked questions about elective surgeries or procedures and COVID-19:

Question: What’s an “elective” surgery or procedure?     

Answer: Elective surgeries and procedures are those that aren’t urgent. They can be rescheduled to a later date if needed. Some examples include:

  • Laser surgery
  • Hernia repair
  • Non-emergent back surgery
  • Colonoscopies
  • Joint replacements

Elective surgery doesn’t mean optional surgery. Be sure to check with your provider if you have questions. To learn more about services covered by TRICARE, visit the Covered Services page.

Question: What’s happening to appointments and elective procedures at military hospitals and clinics?

Answer: Because of COVID-19, your military hospital or dentist may have delayed your surgery or procedure. But you may be able to resume yours soon. In a May memo on the resumption of elective surgeries and procedures, Assistant Secretary of Defense for Health Affairs Tom McCaffrey indicated that military hospital, clinic, and dental commanders or directors may now resume elective surgeries at their hospitals or clinics based on these factors:

  • The installation’s health protection condition levels
  • Health care capacity at the hospital or clinic, and in the TRICARE network
  • Staffing
  • Individual personal protective equipment availability
  • COVID-19 testing availability for patients and staff

“Prioritization of active duty service members will focus first on those deploying or preparing to deploy,” McCaffrey wrote. “And second, on those active duty service members who are integral to sustaining or rebuilding unit readiness.” Check with your provider to find out if they can resume your procedure. You can learn more about this new guidance by going to the Elective Surgeries and Procedures FAQ topic.

Question: Does the policy on resuming elective surgeries and procedures at military hospitals and clinics affect me?

Answer: Are you a TRICARE beneficiary who uses a military hospital or clinic? If so, this policy applies to you. Eligible beneficiaries include but aren’t limited to:

  • Active duty service members
  • Active duty family members
  • Retirees
  • Retiree family members

To see a complete list of eligible beneficiaries, check out the Resumption of Elective Surgery Fact Sheet from the Department of Defense.

Question: Are the referrals or authorization I received earlier still good for approved military or civilian surgeries or procedures?

Answer: To continue to support your access to care, the TRICARE regional contractors are extending end dates for certain referrals and authorizations. This may include elective surgeries and procedures. Under this change, you may be eligible for an additional 180 days extension if your end date is between March 1 and June 30, 2020. Be sure to contact your regional contractor if you have questions. 

Did you know that the Defense Health Agency recently introduced other changes to respond to the national emergency due to the pandemic? In case you missed the four recent changes, be sure to check out this TRICARE article or go to the TRICARE Changes page to learn more.

For more on COVID-19 FAQs, check out ones on face masks, pregnancy, and children.  As you continue to ask important questions, TRICARE is committed to getting you answers. Stay safe, and stay informed.

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Last Updated 6/23/2020