TRICARE PRIME (future lap band patient) needs HELP!

:confused:hey everyone. i had a question about lap band surgery. I just left my PCM's office this morning and he has referred me to Swedish medical center for a weight loss surgery consult. I had a question about getting Triwest to pay for the surgery. I am 5'3 and a 1/2 and weigh 241lbs. my BMI is 42.4. SCARY I KNOW!! I have looked at the TRIWEST website several times and just cant figure some things out and cant get any answers from docs, tricare reps or even the surgery center where i was referred. so i logged on here and am hoping someone can help. Ok so here goes...tricare requires 100lbs over ideal weight with atleast 1 co-morbid OR 200% or more over ideal body weight. The ideal body weight for my height according to the metlife chart is 121-135. First.....do they calculate you being 200% or more over ideal weight by the first number (121) or the second number (135). Second....I do have high blood pressure which constitutes a co-morbid as well as asthma (not sure if that is a co-morbid or not). But I am not taking blood pressure meds for my high blood pressure. so my questions are those that i named and also....has anyone had experience with triwest and had a similar situation? what is the likely hood that I will get approved? if anyone can help i would greatly appreciate it!

Thanks!!

hi! I had my lap band surgery monday the 8th and only began all this recently. I have tricare prime and they hardly require anything. I had a bmi of 39 and diabetes with that and they gave me the okay really quickly and now it's done! i don't know why you would be having any problems with tricare. Three of my fellow military wife friends have had the surgery also and all was really easy with them as well!

I have tricare prime and I have not yet been approved but I talked with my PCM about my worries because i am not at the 100 over and my BMI is only 36. He told me that tricare will approve you if you are BMI of 35 with 2 comorbidities. I have done all the lab work and my consult is tomorrow AM, psych appt in the afternoon. Tricare does not pay for nutritionist unless their is one on your base. My surgeon requires a $500. program fee which covers the nutritionist. Small price to pay.