Lilpeach_059

I will be July 23 also! Just got my date today. I have a clear liquid pre-op diet for two days. I will be banded in Decatur, Ga at Dekalb Medical by Dr Steinberg.

Just got my date today...July 23, 2009!

Which Tricare do you have? I have Tricare South and they would not tell me my ideal weight! Most of the reps (that I spoke to; about 7 or 8) even said they dont use the metlife chart! So how did you approach/word the question?

I think 200% over would make you 282....i think u could 'gain' that by the time u see ur surgeon.

Maybe if you tell the surgeon that u have a small fram he will put that in the paperwork. but I hear that they usually use medium frame for everybody. I'm 5'5 and 231lbs with no 'real' comorbities according to tricare's website...but my PCM wrote a letter and put my weight at 241 & that I suffered from recurrent abcess, asthma & joint pain. Do you have any possible comorbities?

& Tricare approves everyone for an initial consult & then usually about 4 office visits. & no you don't have to print out the approved office visits & consultation unless u want. The surgeons office should have a copy.

From my experience with Tricare Prime is that they will approve the referral for an office visit as long as its a covered service (ie, gyno visit, endo visit, cardio visit) & they will deny those not covered (off base nutritionist, or psyc). For them to approve a lap band surgery....the surgeon has to submit a packet saying the surgery is medically necessary & if the Nurse at Tricare agrees (& u meet the requirements on Tricare's website)...they will approve it. To answer your question....unfortunately one can still be denied for surgery even after having approved visits to surgeon. But they really have to approve your visits to the surgeon to see if you qualify for the surgery.

I have Tricare prime, but I didnt have to lose any weight. Tricare only wanted the info that the surgeon (varies by surgeon) deemed necessary like psyc eval, TSh level, pulm clearance and nutrition consult. Now that I am approved the surgeon can tell me to "jump thru hoops" before he will do the procedure. But I hear you can go to a MTF w/o going thru so much because Tricare will automatically cover it.

Aww sorry to hear that! When I went to my PCM I said I just need you to send Tricare my authorization for lapband surgery :thumbup:...really didnt ask :cursing: but maybe you wont need her permission...maybe if the surgeon deems it medically necessay that will be enough! But my PCM was supportive!

Yea I figured the range would be a a little high, thats why I recommended credit repair. Going from a 615 to 675 can be done in a few months with the things I recommended--as well as paying off accounts that will make your score rise, and not the ones that will make your score drop. My most recent client went from a 516 to 535 in less than 2 months by following some of these guidelines! :tongue2:

Sorry to hear that. But as stated before, can you go to a MTF? Also do you have another parent, if so does he/she have a civilian job that offers a different health insurance plan?

Im under 25 also, and I kept calling Tricare (South) and asking which height/weight chart were they going to use to determine my "ideal weight," since the one online is for people 25 and up. I dont know if this helped...and also my packet had 3 different weights and 2 different heights!! (5'5 and 231 lbs, 5'5 and 253~lbs and 5'4 &1/2 and 241lbs) To get to 253 I used anke weights To get to 241 the nurse asst "made an error" (she was so nice) To get my height at 5 4&1/2 (I told them I wasnt 5'5!) Im really 5'5 231lbs With Tricare Prime you have to go see your PCM before you can go to a specialist and my PCM weighed me twice, and the surgeon once...so thats how I got 3 diff weights. Also, I would have the surgeon and PCM (if applicable) to write a letter with all the comorbities and hopefully they will misread and think you have sleep apnea! I had 2 letters from my PCM, one had my co-morbities as joint pain, asthma and recurrent skin abcess. but everytime I called Tricare- they stressed that if the surgeon deems the surgery medically necessary then they will likely approve it. Another thought...have you tried going on base?

If you are still considering the credit route I have a few pointers: To increase your score- DONT pay off everything--big mistake. You need active credit. To get some active credit, secured credit cards are very good and anybody can get one. There is one with Orchard bank (www.orchardbank.com) and when you get the card keep the balance slightly below 50% (just use it on everyday stuff, you know). I recommend Orchard becaue they report to all 3 credit bureau's more than once a month and this means your score will rise very quickly. If you are not familiar with secured credit cards- google it first so you will have a better understanding before you get it. Also, if you have family members who have had credit cards (secured or unsecured) for years with a great payment history; have them add you as an authorized user. Tell them to destroy the card when it comes in the mail and not to give you any account information so they will be sure that you cant use the actual card. Instantly your credit reports will show that you have had card "X" for "Y" amount of years- and boost your scores. And you dont need to use the card, you just need it to show on your reports. By the way- I dont work for orchard bank I work in real estate and believe it or not a 615 is not a bad score. You can buy a home with a 620. Anywho we work with people needing credit repair (and they pay for this info) but I figured I would share it with you since you are in need of assistance. Any other questions- feel free to ask. Good luck to you!

I know this is a pretty old thread, but I was wondering if anyone else had MRSA before the band? I had boils (a few had to be drained) from August 2008 to January 2009, so I havent had a boil for almost 6 months. I go for pre-op soon and Im hoping they swab me for MRSA. Im hoping that complications due to previous case of MRSA wont hinder my healing after band placement. thx

I know this is pretty old, but has anyone else got the band AFTER having MRSA? I

How long after your pre-op appt did you have to wait to get a surgery date? Im soo waiting on my date!

Add me, havent got an official date...but I know it will be July! I have Tricare, Im 22 getting banded by Dr Steinberg in Decatur, Ga. Im also sooo very excited, yet very nervous about the actual procedure.

Thank you sooo much! Same to you!

I got my approval within 5 hours with Tricare!! The system has a surgery date of July 22 for me, but I do not know how true that is...the new patient coordinator at the surgeons office stays very busy and I havent heard from her. :-(

It says "Lap place gastr adj dev." Place of treatment : (the hospital that the surgeon works at) Case Type :Evaluate and Treat (and other services)Submitted Date:06/18/2009Approved Date:06/18/2009Type of Service:Bariatric surgery outpatient one visit So hopefully this is a yes!!!!:thumbup:

Approved!!!! In a matter of hours!! I was worried for nothing!! Im 5'5 (had my PCM put 5 4and1/2), starting weight was 241 and like 256 (been on this road for a while) but I dont know which Tricare considered. Also had PCM write letter saying joint pains, asthma and recurrent abcess. Then I had the stuff that the surgeon made me do (psyc, pulm and nutrition consult and seminar and TSH level). Cant wait till im banded!! Also my labs and consults were 1 and 1/2 years old!

Ok, I have Tricare Prime, and I need to know what is your "ideal weight" if you are under age 25?? Im 22 years old, and I think I meet the 100lbs over, and I had my PCM write a letter for joint pain, recurrent abcess and asthma. I wanted her to write "severe arthritis of weight bearing joints" but Ive never been diagnosed as that. Tricare says they dont use the Metro Life chart (which is for individuals 25-49 years old)!! They (Tricare) said the surgeon has to say that it is medically necessary!! (Yea I know that but what ideal weight does Tricare use?) Ive spoken to a handful of reps and Im tired of calling! :w00t: Someone please help, any advice is appreciated. I know I can just have the packet submitted, but I dont want to get denied! :blushing:

Im glad to see this thread. I have been in the process of getting my band for almost 2 years. Im hoping to have it in 2 months. Everytime I get close to getting it my mom reminds me of the dangers of anethesia...but I have also had a few minor procedures (99% of them she told me to do), but I guess I have to pray and just keep reminding myself that the risks of dying from obesity are much higher (especially considering my family history). Thanks for asking this. :-)

Oh, I see...I used the small frame. (b/c I heard u get to pick your frame:confused:) Anywho, since I am only 20 years old...has anyone seen a chart for ideal weight for a 20 y.o. female patient at 5'5?? I have found some, but they are difficult to read...

Correct me if Im wrong...but if your starting H/W was 5'4 254lbs, then you are 200% over your ideal wt for your height, which happpens to be 114-127. At 200%, then no comorbidity is required...is this your correct starting Ht and Wt?