TRICARE covers most transplants that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. when the beneficiary has been evaluated and deemed a suitable candidate for transplant.
- You must have prior authorization from your regional contractor
- Donor costs are covered when the donor or recipient are TRICARE beneficiaries.
When the donor isn't a beneficiary:
- Coverage of donor costs are limited to costs directly related to the transplant procedure.
- Other treatments for the donor, including complications won't be covered by TRICARE.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessary and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 6/18/2020