Does TRICARE Cover Orthotics? 2026 Rules & Costs | TRICARE.com

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## Quick answer TRICARE covers custom-made orthotics (shoe inserts) only when they are part of a leg brace or if they are required for the treatment of a specific medical condition like systemic diabetes or peripheral vascular disease. TRICARE does not cover routine, over-the-counter, or "comfort" orthotics, nor does it cover inserts for simple flat feet or "tired feet."

Details

TRICARE follows strict guidelines regarding what qualifies as "medically necessary" for foot-related durable medical equipment (DME). Whether you are covered depends largely on your diagnosis and the type of orthotic being prescribed.

### Custom Arch Supports and Shoe Inserts Standard arch supports and shoe inserts are generally **excluded** from coverage. According to TRICARE policy, these items are considered "not a benefit" if they are used for: * Treatment of flat feet (pes planus). * Correcting posture. * General foot strain or fatigue. * Providing comfort or shock absorption.

### When Orthotics ARE Covered TRICARE will cover orthotics under specific circumstances, often requiring a prior authorization: 1. **Systemic Disease:** If you have a condition like diabetes or a vascular disease that leads to foot complications, custom orthotics may be covered to prevent ulcers or further injury. 2. **Part of a Brace:** If the orthotic is an integral part of a covered leg brace, it is usually covered as part of that orthopedic appliance. 3. **Orthopedic Shoes:** These are generally only covered if they are an integral part of a brace. Coverage may also apply for "diabetic shoes" under specific preventative medicine guidelines.

### Costs for 2026 If the orthotic is deemed medically necessary and covered: * **Active Duty Service Members (ADSMs):** $0 out-of-pocket (requires a referral and must go through a military clinic or a network provider). * **Active Duty Family Members:** In 2026, those on TRICARE Prime pay $0 when seen in-network. For TRICARE Select, catastrophic caps and deductibles apply; after meeting the deductible, the cost is typically 20% of the allowable charge. * **Retirees:** Depending on your plan (Prime or Select) and beneficiary group status, you may face a copayment or a percentage of the cost (often 20–25% for Select).

### The "Podiatrist vs. Primary Care" Rule To get coverage, the orthotics must be prescribed by a physician (MD, DO) or a podiatrist. For Prime members, you usually need a referral from your Primary Care Manager (PCM) to see a specialist who can order the orthotics.

## Who this affects * **Active Duty Service Members:** Full coverage if medically necessary for duty. * **Active Duty Family Members:** Covered with a medical diagnosis of systemic disease or as part of a brace. * **Retirees & Families:** Covered under the same medical necessity rules; cost-sharing varies by plan. * **National Guard and Reserve:** Covered for those on active duty or enrolled in TRICARE Reserve Select (subject to medical necessity).

## Sources * **TRICARE.mil:** [Orthotics Benefit Page](https://www.tricare.mil/CoveredServices/IsItCovered/Orthotics) * **Humana Military (East):** [Durable Medical Equipment (DME) Guide](https://www.humanamilitary.com/provider/benefit-guidance/medical-benefit-search/) * **TriWest (West):** [Provider Handbook and Benefits](https://www.triwest.com/en/provider/provider-resources/) * **Health.mil:** [TRICARE Policy Manual 6010.60-M](https://manuals.health.mil/)