Kimberly Johnson

For Tricare it starts with the PCM, I just thought there would be more of a discussion

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So just completed my first appointment, very lacking of information. I guess I understand. So apparently the process is to see your PCM, they determine your BMI and simply send a request off to tricare for approval. They said once approved, they will assign me a surgeon to see.

I assume the surgeon will be the one assigning Dr appointments and required classes. Was this similar to anyone else's process?

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I am beyond nervous, tomorrow is my first appointment. Fingers crossed it goes well 🤞

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i know this is an old post, but I am seeing my Dr on Friday on Base at Lyster Army Clinic, I would love to hear what all requirements there was and your experience.

I am just so nervous, I feel like I need to know every step for every day. My first appointment is in 3 days, probably why I am so anxious.

I have created a group on FB specifically for Tricare, if y'all want to join. Just to support and figure out the process together. I literally just created it as I did not really find much, at least when I searched.

https://www.facebook.com/groups/359086584533097/

I did and below are the requirements. I do not have doctor documented proof of weight loss, I do have print outs of my fitbit tracker that shows my weight in the last year and my orders from weight loss companies. I do not know if this is enough, as I do not have any health issues that I am aware of.

From below I current meet - age 18 or older and proof of a 44 to 46 BMI. Its just my medicals records, I do not think shows my diet plans over the last 2 years.

All of the following conditions must be met to qualify:

• You're at least 18 years old or you must provide documentation of completion of bone growth.
• You were unsuccessful with non-surgical medical treatments for obesity. Your medical records must show your failed attempts.
  • Diet programs, such as Weight Watchers^®* and Jenny Craig*, are acceptable methods of dietary management, as long as there are monthly clinical visits with your doctor and medical documentation of your participation and your progress throughout the course of the dietary program. *These programs are not covered by TRICARE.
  • Physician-supervised programs made-up of only weight-loss medication management, do not meet this requirement.
• You have proof of one of the following:
  • A body-mass index greater than or equal to 40 kilograms per meter squared (kg/m2); or
  • A body-mass index of 35-39.9 kg/m2 with one clinically significant comorbidity, including but not limited to, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea, Pickwickian syndrome, hypertension, coronary artery disease, obesity-related cardiomyopathy, or pulmonary hypertension.

I just joined this group today and I just scheduled my first appointment today with Tricare, I meet the BMI requirement however, I do not have any known health issues. Is the surgery still a possibility for me? My BMI is between 44 and 46. I am scared of being told no. 10 years ago, I was denied gastric bypass, at almost 300 lbs; I am about 260 now; I am hoping with the sleeve I wil be approved. Do you all have any suggestions or time frames for the Tricare process (Tricare Prime South)

I just joined this group today and I just scheduled my first appointment today with Tricare, I meet the BMI requirement however, I do not have any known health issues. Is the surgery still a possibility for me? I want to be able to avoid health issues from being over weight, is this taken into consideration? Also is there a standard waiting period from time started to surgery date?

I know there are multiple questions in this post, but thanks to all that answer.