Will Tricare pay for surgery to correct Pectus Excavatum?

SPC Private RallyPoint Member — Wed, 17 Oct 2018 15:04:42 -0400

I entered the army last year and the doctor at MEPs didn't know what the "dent" in my chest was, and neither did I, so he let me in with no problems. Recently I have looked into it to discover I have pectus excavatum. Will the Tricare pay for me to have the surgery or would I have to pay for it? For those that don't know what pectus excavatum is it is a deformity in the chest the causes your rib cage to cave in and can force you heart to be displaced which can cause shortness of breathe and heart problems. I would like to get this fixed but I feel like they will tell me the surgery is cosmetic and will not fund it.

Response by SFC Ralph E Kelley made Oct 17 at 2018 4:20 PM

SFC Ralph E Kelley — Wed, 17 Oct 2018 16:20:45 -0400

The problem with sunken chest id that it can interfere with breathing cause, heart problems and also have issues with exersize. The onlt way to know is to ask tricare.
TRICARE covers cosmetic, reconstructive and plastic surgery to improve the physical appearance of a beneficiary only under the following circumstances:
Correction of a birth defect (includes cleft lip)
Restoration of a body form following an accidental injury
Revision of disfiguring and extensive scars resulting from neoplastic surgery (i.e., surgery that removes a tumor or cyst)
Reconstructive breast surgery following a medically necessary mastectomy
Reconstructive breast surgery due to a congenital anomaly (birth defect)
Penile implants and testicular prostheses for conditions resulting from organic origins or for organic impotency
Surgery to correct pectus excavatum
Liposuction when medically necessary
Panniculectomy (tummy tuck) performed in conjunction with an abdominal or pelvic surgery when medical review determines that the procedure significantly contributes to the safe and effective correction or improvement of bodily function.