TRICARE vs. VA Benefits for Crutches: A Straight Comparison
If you're a military retiree with both VA health care and TRICARE, you've probably wondered at some point which one you're supposed to use for what. The two programs are separate, they don't talk to each other, and they don't always work the same way. It's genuinely confusing.
So let's just lay it out: what each program covers for crutches, what it'll cost you, and which one makes more sense depending on your situation.
The first thing to know: these are completely separate programs
VA health care and TRICARE are run by different agencies and funded differently. One is the Department of Veterans Affairs. The other is the Department of Defense. You might be eligible for both, but they won't pay for the same thing twice.
That means when you need crutches, you pick one program to use. They don't stack.
How VA health care covers crutches
If you're enrolled in VA health care and a provider prescribes crutches as medically necessary, the VA covers them through their Prosthetic and Sensory Aids Service. For veterans with service-connected disabilities in Priority Groups 1 through 6, that usually means zero out of pocket. Veterans with a 50% or higher rating pay nothing for any VA care at all.
You can also request a specific brand. The Request for Service form has a field for brand and model, so if you ask your provider to specify in-Motion crutches by Millennial Medical (HCPCS code E0110 for forearm or E0117 for underarm), that's what gets ordered.
How TRICARE covers crutches
Yes, TRICARE covers crutches when a doctor determines they are medically necessary. Coverage runs through civilian providers, and your cost-sharing depends on which TRICARE plan you have. Standard TRICARE plans typically require some cost-sharing on your end.
TRICARE will cover what's medically standard for your situation. If the specific model you want is considered beyond what's medically necessary, that's where things can get complicated. The right billing code on your prescription matters here.
TRICARE for Life: what retirees really need to understand
If you're a military retiree who's also eligible for Medicare, you have TRICARE for Life. Here's how it works in practice: Medicare Part B covers 80% of medically necessary DME after your deductible. TRICARE for Life then picks up most or all of the remaining 20%.
For a lot of retirees, that means crutches at zero out of pocket. Medicare pays 80%, TFL pays the rest.
The catch: you have to be enrolled in both Medicare Part A and Part B to keep TRICARE for Life. Drop Part B and you lose TFL. And since Medicare has its own rules about specific crutch models, it's worth confirming coverage for your specific item before you commit.
Always confirm that TRICARE for Life will pick up the remaining 20% for your specific DME item before assuming you'll pay nothing. Coverage details can vary.
Side by side
| VA Health Care | TRICARE | TRICARE for Life | |
|---|---|---|---|
| Who can use it | Veterans (most discharges) | Active duty and retirees | Retirees with Medicare A and B |
| Typical cost for crutches | $0 for most vets | Varies by plan | Often $0 with Medicare |
| Enrollment required | Yes, VA health care | Yes, TRICARE plan | Yes, Medicare A and B required |
| Can you request a brand | Yes, on the RFS form | Yes, through provider | Yes, through provider |
| Network | VA and community care | Military and civilian | Medicare-authorized providers |
| Covers replacement | Yes | If medically necessary | If medically necessary |
Which one should you use?
Honest answer: it depends on your situation.
You have a service-connected disability and are enrolled in VA health care: Use VA benefits. For most vets in Priority Groups 1 through 6, it's free, and you can request your specific brand through the RFS form.
You're a military retiree with Medicare and TRICARE for Life: TRICARE for Life is often easier for getting a specific brand because you're going through civilian providers. Medicare plus TFL can land you at zero cost. Confirm the specific HCPCS code is covered first.
You have both VA health care and TRICARE: Use whichever fits the situation. Urgent? Use whoever's in front of you. Planned need? Compare how long each process takes and which gives you more flexibility on brand.
You only have TRICARE, not VA enrollment: TRICARE covers medically necessary crutches. Make sure your provider includes HCPCS codes E0110 or E0117 on the prescription.
Free download: What to bring to your appointment
We put together a one-page reference sheet you can print and bring to your provider. It includes the product name, billing codes, a provider script, and a quick checklist, whether you're going through the VA or TRICARE.
Download the VA Appointment Reference Sheet (PDF)
Bottom line
You have real options. Whether you go through VA benefits or TRICARE, in-Motion crutches are FDA-cleared, properly coded under E0110 and E0117, and available through both programs for veterans who qualify. You don't have to take the generic pair off the shelf.
Not sure which program applies to you? Call us at Millennial Medical. We'll help you think it through. millennialmedical.com
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More in the Veterans Series
All six posts in this series are linked below. They're written to stand alone, but they work best together.
- Post 1 of 6: Does the VA Cover Crutches? Yes, Here's Exactly How It Works
- Post 2 of 6: How to Get the Crutches You Actually Want Through the VA
- Post 3 of 6: TRICARE vs. VA Benefits for Crutches: A Straight Comparison (this post)
- Post 4 of 6: HCPCS Codes E0117 and E0110: What Veterans Need to Know
- Post 5 of 6: Getting Crutches Through the VA Community Care Network
- Post 6 of 6: The Best Crutches for Veterans and Why Standard-Issue Falls Short
All posts are also available on our Veterans hub page.
This guide is part of our VA Benefits Crutches Resource Hub, where you'll find every option for getting crutches covered.
