Jesusislove

Hi, I had surgery today, the pain from the surgery is fine, but I am trhrowing up air, the pain is horrible from the gas. I am pretty much pain tolerant, however, this gas pain is something else. I think that walking and the incline helps, this is my first day. I notice when I take the pain medicine it worsens as mommakatx2 said in another post. Hands over the head is working. The incision pain does not really hurt, I am thinking of not taking it until I am in really in pain.

Hi, I had surgery today, the pain from the surfgry is fine, but I am trhrowing up air, the pain is horrible from the gas. I am pretty much pain tolerant, however, this gas pain is something else. I think that walking and the incline helps, this is my first day. I notice when I take the pain medicine it worsens as mommakatx2 said in an earlier post. Are you a nurse? Hands over the head is working. The incision pain does not really hurt, I am thinking of not taking it until I am in really in pain.

Hi, I was instructed by my surgeon at pre-op to do this.

Hi, my surgery is Monday too, I am drinking some stuff called Phososoda to clean me out.

Hi, Portsmouth Naval Hospital in Virginia does it.

Congrats, mommakatx2!

Hi, I am asking for the prayers of the saints. I have surgery on Monday, and I am a little apprehensive because I have never had surgery of any kind. I have lost weight many times with God's help; however, God knows me better than I know myself. I can do all things through Christ that strengthens me. I have taken care of a lot of other people, but it is now time to take care of me. Pray for me.

Hi, are you a 100lbs overweight? Do you have a co-morbidity? If not, those could me reasons why. Let us know what the doc says.

irideagh, you have lost 22lbs in several weeks? You are doing great. Are you still sore or in any pain? I getting ready to go in this month to have the procedure done. Thanks.

H8thew, congratulations. Tricare really does not require a whole lot; you either meet the criteria of being 100lbs overweight with co-morb (for short) or 200% of you weight with no co- morb. My bariatric surgeon required clearances from cardiology, PCM, pulmonology, psych eval, and nutrition eval. Tricare requires none of this, but your surgeon may. I did all this before ever seeing the surgeon, then they submitted my referral after all my clearances and I was approved quickly. I am glad they requested clearances because I have never had any surgery of any kind so I wanted to be cleared too. I was approved before my intial consult with the surgeon. Tricare is the easiest to me to get approved after reading about the other insurances. .

Gina, did you say you did not meet the wieght requirement? You seem like you meet the weight requirement according to what you posted above. Just trying to get an understanding. If you are not a 100lbs overweight they probably will not approve it. Even if you have one comorbidity and you do not meet the weight requirement, there is a great possibility you will not be approved.

Hi, I was just approved. Tricare does not go by BMI. You must be at least 100lbs overweight (acccording to the metropolitan life charts) with 2 co-mordbidities or you must be 200% overweight. If you are 200% of your weight you do not have to have any co-mordbities.

Congrats! Hi, I am right behind you, in April as well.

Hi, look on your insurance website and make sure it is an exclusion, sometimes insurance companies do not want to pay for the procedure. I do believe Mercy hospital/insurance is under the Catholic health initiative, and the organization does not believe in surgeries of this kind. I used to work for them in the corporate offices for Centura health.

Hi, I am tricare prime, I had not seen my bariatric doctor. They got the procedure approval before the first visit. I am approved for the visits and the lap-band procedure. My surgery is in April. Tricare does not go by BMI at all.

I have joint pain in the knee and recent HBP. If you are double your ideal weight 200% with tricare, you will need no co-morbidities. Only those who are 100lbs overweight will need 1-2 co-morbidities.

Hi, I was on meds 10 years ago HBP, came off, and my doctor put me back on them about a month ago. Did your doctor put this down as a co-morbidity, if so I would ask him for the prescription.

I am using Peachtree Surgical Associates, and they are tricare participating providers and they are a center of excellence. You emailed me about what I had to do, well I had to have a pulmonary clearance, a cardiology clearance including an EKG, A PCM letter of necessity. Nutrition eval and psych eval, tricare does not require neither eval, but the bariatric doctor might. I did all of this before seeing the doctor, this is what their center requires. From my understanding, you can see an out of state doctor as long as it is not too far away.

Hi, tricare does not require a 6-month plan; however, I worked out anyway and my knee went out. I had to get physical therapy on my knee which proved that the joint pain I was having will hinder me from working out like I should. Joint pain was one of my co-morbs.

Have no fear, the Lord is the light of your salvation, whom or what shall you fear. God is with you and you have done well. Fear nothing. I rejoice with you on your weight loss.

Hi, so do they pay for fills and what is the code?

Tricare does cover lapband, it is a fact, I called the head office and as of Jan 25, 2008 all systems should be updated, prime and all others.

Minpinmom, have you lost more weight? When you checked your referral online did it say pending at first, and then approved? How long did it take for you to see approved.

Hi, Randi, How much do to the fills cost? If tricare covers fills, they should also cover the fills you have paid for as well. Retroactive for insurance companies means that it will go back and cover what you should not have had to pay from the start. From working in the insurance field, they may cover only what you have paid up until now or up until December. They may request that you go to a MTF, starting now. The question is now, do they cover the fills? I have not found that out yet, but will call next week, I want to make sure everything is updated first, they sound like they can not look up anything unless the computer tells them.

Lapband will be officially updated January 25, 2008 I was told by Humana Tricare that all systems should be updated today in the system for the lap-band procedure, so you should not hear from a Tricare rep that they do not see where its covered. I already had my visits authorized to see my doctor before today, approx. a week ago. You must be 100lbs overweight with comorbidities according to the metropolitan life chart. If you fall 100lbs overweight on the chart you're good. If you should weigh 135lbs and you weight 270 or more, you automatically qualify, that is what 200% means, basically you must be double your weight. BMI has no bearing with tricare only weight and height for you bone structure. Weight and bone structure is based on the Metropolitan life charts. You will eventually need clearances from various specialty doctors and your PCM, nutrition eval, and pschy eval, after your packet is accepted by your bariatric doctor. Last edited by trell : Today at 09:48 AM.