Multiple Prostheses for Injured Active Duty
Friday, October 4, 2019
On October 4, 2019, the Defense Health Agency implemented a benefit change under its Supplemental Health Care Plan (SHCP) that allows for coverage of multiple prostheses for active duty service members (ADSMs) with major limb amputations. Replacement prosthetics will be covered based upon the treating physicians’ determination.
All ADSMs who have sustained an amputation(s) must first get an initial assessment (in person or telephonically) at one of the following Advanced Rehabilitation Center (ARC) locations, as arranged by the ADSM’s military hospital or clinic:
- The Center for the Intrepid, San Antonio Military Medical Center, San Antonio, Texas;
- Walter Reed National Military Medical Center, Bethesda, Maryland; or
- The Comprehensive Combat and Complex Casualty Care, Naval Medical Center, San Diego, California.
If the ARC is unable to accommodate the ADSM, ARC staff will work with the ADSM’s military hospital providers and regional contractor (Health Net Federal Services, LLC in the West Region) to coordinate care by civilian network providers.
Prostheses will be covered regardless of remaining time on active duty; however, once retired from the military, TRICARE’s (not SHCP’s) prosthetics coverage will apply. Under TRICARE, one prosthetic at a time is covered unless a beneficiary requires bilateral prosthetics.
ADSMs who separate or retire from the military may seek replacement and repairs from the ARCs or Veterans Health Administration (VHA), as eligible.
Active duty patients who want to learn more about SHCP can review the SHCP page on our beneficiary portal.
For more information on TRICARE’s prosthetics benefit, visit our Benefits A–Z page.