1000words

I did my exercise 5 on week 1. I have increased my walking speed to 3 mph and my run to 4.5 mph. I have a feeling that I will be on week 1 forever... so far I don't see much reason to move on to week 2 until after my surgery in a week and a half. I actually really am liking the workout I am getting. I am staying on the treadmill until my heartrate drops under 65 percent, which usually keeps me on for another 10 to 15 minutes. But, I do not ached after the workout or the next day. Good luck everyone. Krsi

You must be retired... because Tricare Prime does not have a cost to active duty dependents. If you were active duty Tricare Standard would end up costing quite a bit more than Prime.

My name is Kris. My surgery date is September 9. My goal is to lose another 120 pounds.

I am using Robert Ullreys podcasts. He has them for free download on his site. The music is high tempo, techno-style. And his voice comes on to tell you when to start and stop running. He also tells you when you are at your half-way point in a run session. Podcasts

Are you guys listening to the recordings on an MP3 player too? I find the music and the guy speaking very motivating.

I am so glad to hear that I am not the only one who plans on repeating Week 1. I did my second Week 1 workout today and I made it through it... but couldn't imagine increasing the run times yet. I did find that I had to increase my cool down time by 15 minutes to get my heartrate back down and to get my legs to stop aching. On another note, I ma hoping that Tropical Storm Fay will stop hitting Jacksonville so I can schedule my surgey! Good luck everyone! Kris

I went to the gym today and did the Week 1 run. I did it on a treadmill and stayed at about 2.8 during the brisk walk times and 4 during the running parts. For the most part I enjoyed it. I am just a bit embarrassed and I am trying to get over it. The hard part is that I work out at the gym on the Air Force base and I am basically sorrounded by career military guys that are very much in shape. I made a point of never looking around me to see if anyone was looking, but I am having a hard time getting over the idea of the guys laughing at me wiggle and jiggle. The good part about using the base gym is that I was able to get an aquamassage right after my workout. I love it! I am still pre-surgery. I got my authorization today and just waiting to schedule. (unfortunatley my doctor's office was closed today because of the hurricane) So, I might be quite behind everyone if I am able to get my surgery in the next few weeks. Good luck everyone! Kris

I would like to join in too! I am still waiting to be banded... but I would love to get a head start. - Kris

From what I have heard about Tricare they are pretty much stuck on the concept that you have to be at least 100 pounds overweight to be approved. Which, I am guessing by your BMI that you are not. My surgeon's office told me that you either have to be 100 pounds with co-morbidities or 200% of a normal body weight.... and I luckily qualify in both columns. :biggrin: It is really sad that Tricare is unwilling to help until you are basically in pain and unanable to move well... but at least they are better than most insurances. Good luck.

Thanks for your replies. I am hoping to be banded in August and it looks like that may be a possibility. Does anyone know if they are still planning on moving offices?

I was approved for the surgery through my insurance through another doctor... so I know that will not be a problem. I was just wondering how far out they are scheduling the surgery once you get everything done...a month? six weeks? two months? Kris

I went to my group seminar on Monday and now I am scheduled to see Dr. Baptista on July 2. I was hoping to get in sooner to see him... but they only see new patients one day a week. I have all my files, lab work, ekg, x-rays and letters done. (I was actually approved for the surgery with another doctor but at the last minute the hospital decided not to take Tricare.) I am under the impression that it will be rather simple for them to get the authorization. So, my question for all of you is how long after you had everything turned in to the Jacksonville Weight Loss Group did it take for them to submit it to the insurance? And, after you had the approval, how long did it take to get the surgery done, or how far in advance did they book to date? I am just hoping that if I go in for my visit on July 2 that I will be able to have my surgery the first week of August. Thanks for any info you can provide.

You can take me off June 9... due to some insurance problems I have to go to a different surgeon now.

I spoke to several people at Tricare the past few days. Even a participating provider can refuse to do a service that they believe Tricare does not pay enough for. So, basically since Tricare will not pay them enough for the lap band they will not perform the surgery. I am going to call the hospital tomorrow and see if anything changed. I am not holding my breath.

I guess I worded things wrong... it is not the doctor that is the problem, it is the hospital. The doctor said he would do the surgery for free... but the hospital is not willing to budge on their minimum acceptable amount. I wish I would have found this out months ago so I wouldn't have bothered with this program and went ahead with an established tricare lapband provider.

kitty- I know what form you are talking about... but this was NOT the standard pay if your insurance doesn't form. It was explained to me by both the hospital and a patient advocate at the Tricare Service Center that if I signed that form I would be giving up my rights not to be billed for the remainder of the bill that Tricare does not pay. I said I would be willing and required to pay the balance that my insurance does not pay. According to someone at Tricare this is a way a lot of hospitals get away with coming after Tricare patients... the form basically screws the patient over. Apparently any doctor can refuse to do an elective procedure if they do not believe Tricare will pay enough... they can not be forced even if they are a Tricare provider.

Apparently there is nothing I can do. I spoke to Tricare and a hospital or doctor can decide at any time that they do not want to do a procedure. Basically, they can not be forced to lose money. I went as high as the CFO at the hospital. We agreed that he would submit the codes to tricare to get an official amount of what would be paid. I know it will be less than he wants. The truly rude thing is that I found all this out when I went in for my pre-op appointment today and they asked me to sign a bunch of forms. Instead of having the usual form that you sign saying you will pay if your insurance does not pay... it was a form that said that I would bay the BALANCE after my insurance pays. I called Tricare and they said that although balance billing is not allowed, that if I sign the form I am waiving that protection. The bitchy lady actually told me that it was cosmetic surgery and the hospital was not going to take the finacial liability on that... and then told me that most people pay for the surgery. That was followed by two hours of sitting in the hospital hallway upset while my surgeon, the obesity nurse coordinator and the CFO met. The whole day was bad, bad, bad. I am still sick to my stomach. I have been on the pre-op diet for three weeks now and wondering if I should continue.

So... I got my referral, then my approval and then a surgery date. I was going to be the first tricare lapband patient at the hospital. I went for my pre-op today and a bomb was dropped on me. Apparently the hospital checked with tricare and found out how little they would pay and have decided not to take my insurance. Both the hospital and the doctor accept Tricare... but have decided not to take it for the lapband. I feel a bit betrayed, by the hospital... but I do understand since apparently Tricare would only pay about $850 over the cost of the lapband. But, I wish they would have figured this out a few months ago before they led me along. So, I am now shopping for a new surgeon. My surgery was scheduled for June 9... I will be lucky to get in to see a new surgeon by that date. Does anyone who have Tricare have a copy of their explanation of benefits of what was actually paid for the surgery?

Congrats on the approval. Hopefully you will get a surgery date soon.

I am not being done by Bagnato... but am getting my surgery in Valdosta by McCowan, who works with Burnette, who does the port placement like Bagnato. :sad: I was hoping to get information from you about port placement on the chest area. I do not wear low cut blouses, but I tend to scar badly, so I hate the idea of the port scar showing. How was it decided for the exact location of the port? Does your port scar show when you are wearing you bathing suit or bra? I know that I am just sweating the small stuff, but I just do not want a odd scar that I have to explain to people that do not know about the surgery. Thanks for you info

I am in Valdosta, GA and getting banded on June 9 too. Good luck to everyone! I have been doing sugar busters for the past few weeks... but have only lost a few pounds. Only 12 days until surgery!

Wow... there are a lot of June '08 banders. Can you please add me to the list. I am scheduled for June 9. :sad: Thanks!

Well... even though Tricare doesn't require it... a lot of doctors do require the pscy and nutritionist consult. The thing with the psych consult is the only way Tricare will pay is if it is to treat something other than weight loss... for instance I had to go for depression. Good Luck

I want to squash any thoughts of this being an urban legend... I did a search and found this CapeCodOnline.com

The only thing I had to pay for was the nutritionist... which was a waste of $156, but it was part of the process. For the psychologist I went through Tricare Value Options and the appointment didn't cost me anything since I went with a Tricare provider. I did not need a referral for the psychologist, I was able to self refer. The obesity center was able to recommend a band-friendly psychologist that was on my list. It looks like my surgery is going to be on June 9. Hopefully everything is smooth sailing until then.