Medical Group commander added to elective surgery approval process Published April 4, 2012 By Airman 1st Class Frank John Casciotta 71st Flying Training Wing Public Affairs VANCE AIR FORCE BASE, Okla. -- Airmen seeking elective surgery must now add the 71st Medical Group commander to the list of approvals they need before going "under the knife." Elective surgery on active duty members performed off-base and not coordinated or approved by the medical treatment facility and Tricare is prohibited without prior written approval of the member's squadron commander and the medical group commander. If approved, the elective surgery is at the member's expense and is not a covered benefit. Surgeries such as breast augmentation or reduction, laser eye surgery performed by a non-military treatment facility provider, abortions and cosmetic surgeries are examples of surgeries considered elective. If elective surgery is approved, active duty Airmen must pay for it out of pocket and have enough annual leave saved up for recovery time, said Sharron Schaefer, the chief of Tricare Operations and Patient Administration Flight with the 71st MDG. The first step in the approval process for elective surgery is to schedule an appointment with a primary care physician for an exam. The Airman seeking approval for elective surgery then meets with Schaefer for a briefing outlining limitations on compensation available if the elective surgery causes complications. After the required briefing, the Airman must get signed approval from both their squadron commander and the medical group commander before the final package is sent to the Air Force Personnel Center, Randolph Air Force Base, Texas. "How much someone decides to disclose about their surgery to their commander is up to the individual," said Schaefer. "The commanders are not approving or denying whether or not the individual can have the surgery. They are assessing the risks and duty impact of the proposed surgery and recovery time." The addition of the medical group commander to the process took effect Jan. 12, 2012. "The reason for the newest step is to ensure Airmen are not doing something that could be detrimental to their mental or physical health or to the mission," said Schaefer. Once the Airman has all the necessary local approvals, the paperwork is sent to AFPC for final approval. Permission should be obtained prior to paying any non-refundable deposits, such as medical fees, airline tickets or travel costs. The potential for lost deposits will not be a factor in the decision. There are some cases where elective surgeries are actually medical issues and are no longer considered elective. "If there is at least one year of documentation of pain in the shoulders or pain in the back based on a woman's large breasts it becomes a medical issue and breast reduction is no longer considered an elective procedure," said Schaefer. Abortions can also be an exception under certain circumstances. For instance, abortions are not considered elective if a pregnancy is a result of a rape or endangers the mother's life, said Schaefer. Elective surgical procedures for weight reduction are prohibited. This type of surgery endangers the integrity of physical training tests by altering the body using surgery for weight management, said Schaefer. For more information, contact Sharron Schaefer at 213-6343.