TRICARE Coverage for Skin Conditions and Dermatology | TRICARE.com

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## Quick answer TRICARE covers the diagnosis and treatment of medically necessary skin conditions, such as acne, psoriasis, eczema, and skin cancer. While routine care from a Primary Care Manager is standard, specialized treatments like laser therapy or surgery are only covered if they are not considered cosmetic in nature.

Details

### Coverage Basics Most skin conditions are treated under TRICARE's medical benefits. If you have **TRICARE Prime**, you generally need a referral from your Primary Care Manager (PCM) to see a dermatologist. If you have **TRICARE Select**, you can visit any TRICARE-authorized dermatologist without a referral, though your out-of-pocket costs will be higher.

### Covered Conditions and Treatments TRICARE covers professional services and supplies required to treat: * **Medical Dermatitis:** Including eczema, rosacea, and severe psoriasis. * **Infections:** Bacterial, fungal, or viral skin infections. * **Skin Cancer:** Biopsies, surgical excision, and Mohs surgery. * **Cyst Removal:** Only if the cyst is infected, painful, or interfering with function. * **Prescription Topicals:** Managed by Express Scripts, including medicated creams for acne and inflammatory conditions.

### The "Cosmetic" Exclusion The most critical distinction for TRICARE coverage is whether a procedure is **medically necessary** or **cosmetic**. TRICARE will not pay for: * Removal of benign skin tags or moles for appearance only. * Chemical peels or laser treatments for aging or sun spots. * Treatment for "routine" acne or scarring that does not meet medical necessity criteria. * Laser hair removal (unless part of a gender-affirming care plan under specific guidelines or treating a severe medical condition like hidradenitis suppurativa).

### 2026 Out-of-Pocket Costs Costs depend on your beneficiary category (Group A vs. Group B) and your plan: * **Active Duty Service Members (ADSMs):** $0 for all covered dermatological care. * **Active Duty Family Members (Prime):** $0 for covered specialist visits with a referral. * **Retirees (Select):** Will pay a deductible and then a cost-share (approximately $35–$55 per specialist visit, varies by plan year — check TRICARE.mil for current 2026 rates). * **Pharmacy:** Generic topical medications are typically $16 for a 90-day supply via Express Scripts Home Delivery (2026 rates).

### Regional Management * **East Region:** Managed by Humana Military. * **West Region:** Managed by TriWest Healthcare Alliance (as of the T-5 contract transition).

## Who this affects * **Active Duty Service Members:** Requires PCM referral for all dermatology. * **Active Duty Family Members:** Covered under Prime or Select. * **Retirees and their Families:** Subject to cost-shares and deductibles. * **National Guard and Reserve:** Covered under TRICARE Reserve Select if enrolled. * **Survivors:** Maintain coverage based on the sponsor's status.

## Sources 1. TRICARE.mil - Covered Services: https://www.tricare.mil/CoveredServices/IsItCovered 2. Humana Military (East Region): https://www.humanamilitary.com/ 3. TriWest Healthcare Alliance (West Region): https://www.triwest.com/ 4. TRICARE Pharmacy Program (Express Scripts): https://www.tricare.mil/pharmacy