I had my sleeve done last August with Tricare West and it was absolutely effortless! I asked my primary (civilian) for a referral, and then I called a few days later and scheduled my consultation with the doctor at the local hospital, who was amazing. His office had the referral in their system already, and they took it from there. The six months of required weight loss classes, the nutritionist appointment, the psychological consult (done on the same day in his office) were all included and cost me nothing. A month before the surgery, I had my pre-op bloodwork and paperwork done at the hospital and EKG done, no charge. I was referred for an echocardiogram which cost me a $30 copay. The day of the surgery I paid a $150 copay at the hospital as I was staying overnight. That was IT. My doctor took care of ALL the footwork and final approval with Tricare, all I had to do was show up. They were very strict, however on the six months of supervised classes. I had to go on the same exact day each month and could not miss a class or change the day without the risk of Tricare making me start over. Worth. All. Of. It. Please let me know if you have any questions, my surgery was done at Parker Hospital in Aurora, Colorado.