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Provisional Coverage Program

The Provisional Coverage Program covers some emerging services and supplies.

What do I need to know about the Provisional Coverage Program?

  • We require prior authorization for all services and supplies in the program regardless of your TRICARE plan.
  • We’ll offer provisional coverage for any approved service or supply for up to five years.
  • We can end provisional coverage for any approved service or supply at any time.
  • Before the five year provisional coverage expires, we’ll determine if the service or supply becomes a permanent benefit.

Provisional Coverage of Surgical Treatment of FAI

What is FAI?

FAI is a condition that affects the hip joint. It occurs when some portion of the soft tissue around the hip socket gets pinched or compressed. It causes pain that limits a person's mobility.

What is the provisional coverage for treatment of FAI?

TRICARE covers surgical treatment for FAI when you meet certain criteria. We cover surgical treatment that's open, arthroscopic, or a combined approach. The goal of the hip surgery is to improve the hip joint range of motion and improve or alleviate pain by restoring normal anatomy.

How do I know if this treatment is right for me?

You'll follow your plan's rules for getting care. 

Generally speaking:

When does the provisional coverage of FAI begin?

  • Provisional coverage of FAI begins on January 1, 2016.
  • There is no retroactive coverage.
  • It will end on December 31, 2020 unless we end it early or it becomes a permanent benefit.

How much will it cost?

Your plan and where you get the surgery determines your cost. >>View Your Costs.

What if I still have questions?

If you still have questions, please contact your regional contractor.

Last Updated 8/21/2017

contact Your Contacts
North-Health Net

1-877-TRICARE
(1-877-874-2273)

North Region Website


South-Humana Military

1-800-444-5445

South Region Website


West-UnitedHealthcare

1-877-988-WEST
(1-877-988-9378)

West Region Website


Overseas-International SOS

Country-specific toll-free numbers

Overseas Website


TRICARE For Life

In the U.S. and U.S. Territories, contact WPS-Military and Veterans Health:
1-866-773-0404
(TDD 1-866-773-0405)

In all other overseas areas, call International SOS

www.tricare4u.com


US Family Health Plan

1-800-74-USFHP
(1-800-748-7347)

US Family Health Plan Website


View More Contacts