Does TRICARE Cover Dermatology? (2026 Costs & Rules) | TRICARE.com

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy and enrollment, visit TRICARE.mil.*

## Quick answer Yes, TRICARE covers dermatology services when they are medically necessary to diagnose or treat a skin condition. While medical issues like skin cancer or psoriasis are covered, TRICARE specifically excludes purely cosmetic procedures like Botox for wrinkles or laser hair removal.

Details

TRICARE’s coverage for dermatology depends on your specific plan and whether the condition is classified as medical or cosmetic.

### Referral Requirements Referral rules vary significantly based on your status and plan: * **TRICARE Prime (Active Duty):** Active duty service members (ADSMs) always need a referral from their Primary Care Manager (PCM) for any dermatology visit. * **TRICARE Prime (Family/Retirees):** You generally need a referral to see a specialist. If you see a dermatologist without a referral, you will be charged higher "Point-of-Service" fees. * **TRICARE Select:** You do not typically need a referral; you can see any TRICARE-authorized dermatologist, though staying in-network reduces your out-of-pocket costs.

### What is Covered (Examples) TRICARE covers services that are "medically necessary and appropriate." This includes: * Skin cancer removal and biopsies. * Treatment for chronic conditions like eczema, rosacea, and severe acne. * Removal of infected or painful moles/cysts (subject to pathology review). * Treatment for port-wine stains or hemangiomas that interfere with vision or breathing.

### What is Excluded (Cosmetic) TRICARE strictly prohibits coverage for cosmetic surgery or procedures intended solely to improve appearance. This includes: * Removal of benign skin tags that aren’t causing medical issues. * Chemical peels or laser treatments for aging or sun spots. * Botulinum toxin (Botox) for facial wrinkles. * Treatment for "complications" arising from previous non-covered cosmetic surgeries.

### Cost-Sharing (2026 Rates) Costs depend on your beneficiary group (Group A vs. Group B) and plan type. * **Active Duty:** $0 for all medically necessary specialty care. * **TRICARE Prime (Retirees):** Typically a fixed copayment per specialist visit (e.g., ~$38–$45 depending on specific 2026 tiers). * **TRICARE Select:** Benefit from "contracted rates" in-network; you usually pay a percentage of the allowable charge (15-25%) after your annual deductible is met.

## Who this affects * **Active Duty Service Members:** Requires a PCM referral; $0 out-of-pocket. * **Active Duty Family Members (ADFM):** Covered on Prime (with referral) or Select (no referral). * **Retirees and their Families:** Covered; subject to enrollment fees and copays. * **National Guard/Reserve:** Covered under TRICARE Reserve Select. * **Survivors:** Coverage continues based on the sponsor's status at the time of death.

## Sources * **TRICARE.mil:** [Covered Services: Dermatology](https://www.tricare.mil/CoveredServices/IsItCovered/Dermatology) * **Humana Military (East):** [Referrals and Authorizations](https://www.humanamilitary.com) * **TriWest Healthcare Alliance (West):** [Provider Network and Claims](https://www.triwest.com) * **Defense Health Agency (DHA):** [Medically Necessary Definitions](https://health.mil)