ii. Self-help courses, relaxation. TRICARE Standard does not cover self-help
courses, or items or charges related to exercising or relaxation, such as spas,
whirlpools, hot tubs, swimming pools, and the like.
kk. Speech therapy, except when related to a specific illness or injury.
Sexual inadequacy treatment.
Surgical sterilization reversals.
nn. Telephone services or advice (except in TRICARE regions), including remote
monitoring and consultation, except for trans-telephonic monitoring of pacemakers.
Other types of diagnoses or monitoring by telephone may be available. Check with your
HBA or TSC for details.
oo. Weight control or weight reduction services and supplies, except for certain
surgical procedures when specific conditions have been met.
pp. Workers' compensation. TRICARE Standard will not cost-share work-related
illnesses or injuries that are covered under workers' compensation programs.
Section V. CHARGES UNDER TRICARE
1-13. COST SHARING
a. General. TRICARE is essentially a supplemental program to the uniformed
services direct medical care system. In many of its aspects, TRICARE is similar to
private medical insurance programs. It is designed to provide financial assistance to
TRICARE beneficiaries for certain prescribed medical care obtained from civilian
b. Scope of Benefits. TRICARE pays for medically necessary services and
supplies required in the diagnosis and treatment of illness or injury, including maternity
care, subject to the conditions, limitations, and/or exclusions discussed earlier and
enumerated in detail in AR 40-400 and TSO 6010.46-H.
c. Basis for Cost Sharing. Benefits for covered services and supplies are
extended on either an inpatient or outpatient cost-sharing basis, in accordance with the
status of the patient at the time the covered services and supplies were provided.
Cost-sharing provisions are covered in detail in later paragraphs.