10 United States Code (USC)
Section 1079(a)(13) provides that TRICARE may only pay for medically necessary
care. This statute has been implemented by the Code of Federal Regulations
(
32 CFR 199.4), which
states that TRICARE will pay for “medically necessary services and
supplies required in the diagnosis and treatment of illness or injury.”
Therefore, TRICARE can cost-share only medically necessary supplies
and services. Services that are not medically necessary are specifically
excluded from TRICARE coverage.