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Thread: Tricare and orthopedic surgery

  1. Regular Member
    HeatherFeather's Avatar
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    #1

    Tricare and orthopedic surgery

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    Have any of you guys ever had orthopedic surgery with Tricare? I can't seem to find consistent information on how this will work.

    Basically, I have been referred to an off-base orthopedic surgeon for my injury. I need to have part of my meniscus removed in my knee.

    Does anyone have experience dealing with Tricare and a similar surgery? I will also need physical therapy afterwards and I'm not sure how all of this will work. :-/

    Thanks!
    Last edited by HeatherFeather; 07-21-2012 at 06:58 PM. Reason: Autocorrect...
  2. Senior Member
    *Stephanie*'s Avatar
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    #2
    If you have a referral on Prime and that doctor says you need surgery and PT they should arrange the authorization and you won't have to pay anything.

    That doctor can generally get you the referral for PT. They may or may not make you go on post depending on space.

    If your doctor takes Prime I'm sure his office is used to dealing with Tricare though so it should be pretty easy.

    I currently have an off base PT referral with 20 appointments authorized. My doctor can call in more if needed.
  3. You are here.
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    #3
    odsh had PT and all he needed was a PCM authorization stating he needed OT and PT at a local therapy place off base. Did that for two years, no problem. Everytime the authorization was up, the admin over at the PT place would file another request for more appointments and it was approved.

    i know a lady whose kids have bone issues and they have had multiple surgeries with ortho and they've never had issues with tricare reguarding payment.
  4. Keep on dreaming little penguin
    dream's Avatar
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    #4
    I've had multiple ortho surgeries and physical therapy rounds, as long as all the referrals are in place there hasn't been an issue.
    BraveLilToaster is the most awesome wifey ever!

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