Your Insurance: TRICARE
TRICARE has covered lipedema surgery, but there are limits to what your surgeon can charge you for services. Because the usual lipedema surgical codes do not have a set price, generally, professional fees should average $8,000. If you have your surgery in a hospital, it may be possible for the hospital to bill TRICARE directly.
We recommend asking TRICARE to cover skin excisions since non-government plans are now covering them.
Even if you have TRICARE Select, it is helpful to have support from your primary care physician. Sometimes, TRICARE is willing to sign a single case agreement with your provider in advance, or you can submit claims after surgery. Because there are different TRICARE contractors and programs, it is important to start this process before surgery, even if you pay cash. We have worked with several TRICARE patients and are happy to develop a customized plan for getting coverage and fair payment.
On December 4, 2020, TRICARE Select West (Health Net) informed us that it would be fully covering lipedema surgery. This is great news for TRICARE West members. However, you will still have to create an effective preauthorization request that confirms your diagnosis and defends your surgery plan. Coverlipedema.com gives you the knowledge and tools to create an effective request that can get your surgery fairly covered.
Your Next Step
Register and start working towards getting your surgeries covered!