formykids2

The new policy with tricare (that doesnt come up on the websites just yet apparently) is not just 40 bmi. It is 35-39.9 with other health issues from the obesity and 40+ bmi with no other health issues. The previously listed comorbidities from the tricare policy book are not the only ones they are accepting anymore so there may be a posibility that they will look at the things you have as a qualifier, but you do have to show that you have had physician suppervised/ medical weight loss attempts that have not been successful. They will accept like weight watchers or whatever diet as long as you are seeing your doctor monthly for monitoring. I really hope that the new policy gets listed on the tricare sites soon so that people can know what is offered and what they are up against to get approved.

Im hoping to have mine a week after you!

I found out that tricare has finally put the new standard in the policy manual that will allow for bmi as the criteria instead of the 100 lb or 200% that has previously been their standard! It isnt posted on the tricare websites yet (they have until mid Sept to do that) but it is on the Tricare Management Activity site in the tricare policy manual. I believe the site is http://manuals.trica...ame=TP02toc.pdf and it is in the section for surgery, and is policy 13.2. I hope people can find the information from this link but if not you can go to www.tricare.mil, click on the TMA tab, go to policy, tricare manuals, click the 2002 policy tab on the left, then under the tricareprogram manuals 2002 section click the one that refers to the policy manual. That should bring up a page that says most recent change number 145, click that section and under it you can see the whole manual at change 145 and it is in chapter 4 (surgery) and it is down at number 13.2. I hope this information can help people who are currently looking into this through tricare since it may open the door for some but could make new hurdles for others to make sure they qualify.

sounds like a plan. if they give me any guff i'll just say show me the instruction (er, uh i mean, show me in writing :-) ) I dont do well at all with this wishy washy stuff and just want a clear cut/ black and white list. I know based on the current weight guidelines that I just by the hair of my chin qualify, and with the new rules coming soon I well fall into that too. I look forward to the appt with them to get it all submitted. By the way, does Tricare want all of the labs and such done before approval or just have it done before surgery?

I appreciate the replies that I have gotten so far, but I know that no other region expects this. My concern is stricktly related to the North Region. I have found that they all pay for it, but that they (the North region) may have different criteria in order to get it approved. I will be meeting with my surgeon in a couple of weeks so I guess we will find out when we actually submit papers for auth.

i know everyone says there isnt supposed to be one, but my question is, is there anyone in north region that had the surgery without the 6 months. I want to know that I have a leg to stand on when I go in and say that they do not have that listed as a requirement. If I have to do it obviously I will, but I would rather get this done sooner rather than later of course.

I have searched many boards, and many sites and still do not have a good straight answer to my question.... Does tricare north require a 6 month supervised diet? I have seen some here say yes, some drs offices say yes, some say no and I did call tricare and 2 different people said they had no idea what i was talking about and that there was NOTHING in their information about that being a requirement or even a request, and i have a neighbor who had the band without the 6 month. So ultimately, my question is has anyone with tricare prime in the north region had this without having the 6 month requirement??

I have a few questions that I hope someone can help me out with... - when we lose weight, is there a place that it usually shows first? is that different with everyone or is it a fairly normal parts that happen in the first stages? - when we buy Protein and it is of course in the big jugs, how long does it last after we open it before it becomes less effective or becomes off tasting? - how long till people are able to carry groceries and laundry and the like after surgery? (I have 5 kids and do a LOT of laundry, lifting of kiddos for baths and getting on bus...) - is it hard to find a dr to continue to do fills if you have to move after you have surgery? - i have seen different things about ab excercise after being banded and would love to know if it is or is not something that is safe, and if things like rock climbing would hurt too. - i think i am only going to tell my neightbors that i had gallbladder surgery because they know that is something that has been a problem and I dont feel like i need to share this decision with them, do you think that will be enough of a reason for things being different with me for a time after while i am healing or will they know that there is more up with me? (outside of the weight loss that is) - what is the psych appt looking for? sorry for all the questions but this seems the best place to ask.

I went to the "seminar" at Sinai hospital yesterday and was NOT at all impressed with the presentation or the dr so I feel confident that he is not the one for me. I was really thinking about the Kane center because I have heard rave reviews on them, but Dr Haggerty is VERY close to me and would be super convenient. I called his office and talked to some staff and was impressed with how kind and informative they were just in the time on the phone so I think I may just go with him. I like the idea of not having to go 45 min+ away from home for a fill, even though the Kane Center has drs right by my sisters house, that may be a real PAIN to do in the middle of winter. I just made another post about it, but I am offically on my way now! I met with my pcm yesterday and he submitted for the surgeon! All I had to do is pick one and start the whole 6 month weigh in/diet junk and the testing that the surgeon wants and will be partying hardy with shakes for Christmas/New Years (that is the 6 month mark so just have to see when he has open!). Cant wait to hear more about everyone else and your journeys!

I met with my primary doc yesterday and got the ball rolling!!! He said i qualify for our insurance to cover and now I have to find who I want for my surgeon and of course jump through the hoops of testing and the 6 month "diet", but I am officially on my way! Looks like my Christmas/New Years time will have an additional celebration added.... YAY! <<<PS... if anyone has any information on Dr Haggerty in Highland Park, IL I would LOVE to hear it because I am thinking of choosing him!>>>

I was looking into Dr. Haggerty at Highland Park hospital! I went to a support group meeting that he led and it was interesting. I am also looking at the Kane center and a dr at Sinai hospital.

Oh how I love to hear others have the same wishes! Mine definitely include rock climbing, running after my kids and them not leaving me in their dust!, finishing a 5k, and actually wearing "nighty" type things without having to turn the lights off to hide myself!

ME! I live in a north suburb and am in the process of finding my doctor now!

HI! I have been lurking and reading LOTS on this board and am SO happy to have found it! I am currently starting my path to getting lap band and really love all of the info that I am absorbing here. I do have family and friends who have had successful lab band placement and had pretty much decided this is the path for me, but I have learned so much more from reading things here than I would have even thought to ask before reading. Anyway, just wanted to say hi and I look forward to "meeting" more of you and getting involved in the forum!