talkalot1981

If you search the forum there is alot of stuff on Tricare denials/approvals. The insurance/financing part has alot of info also...Jennifer

Kat- I have heard of people getting denied for only 1 lb under the 100 lb mark. I had to gain 6 lbs to qualify. My scale sucked at home and I ended up gaining 13 lbs instead. ARGG:cursing: So I sure do hope I qualify or I would have gained for nothing. Anyway, I hope you get approved but I know Tricare is knit picky about certain things. Jennifer

Try to schedual all of you appointment for labs, EKG, UGI, ect as soon as you see your PCM. It has happened fast for some people. I have been waiting since April. well actually march but it is a long story. My fault. Anyway, just try to get everything that needs done, really fast. Sorry I can't be more help. Jennifer

Congrats, I too am waiting for approval. It has only been submitted for 2 days but I sure do hope it isn't much longer. I swear I am driving myself crazy. I hope we both get approved soon. I will keep you in prayer, please remember me in yours. Jennifer

Well I wonder about someone like me. I mean my family is military and we move almost every 4 years. What do I do then? I am sure Tricare had to refer me to a new surgeon but what if he rejects the referral? I know I am here in Alaska for the next 2 1/2 years, so I hope all goes well... Jennifer

Crap!!! I just called Tricare and asked why my fills were approved but the surgery says pending review. She lady said it is because a medical professional needs to review my stuff. She said don't assume I am approved. ARGGG I was so happy to see the fills were approved but now I have to sit and wait.... ARG:cursing:

The same as Kat here! I also didn't have to take any test. Although my mother did. I also have slight depression/anxiety. That didn't prevent me from getting approval from the psychiatrist(sp) She didn't even ask why I was on the meds. She just wanted to know what I knew about the surgery and what to expect afterwards. Right now I am just waiting for a date..... Jennifer:lol:

I am sorry about that. I didn't have any security code. I get so nervous about having to wait if I didn't do the online thing I would probably call Tricare everyday. LOL Jennifer

signing up for the website doesn't take long. You get access with in seconds of signing up. I didn't have to wait. I found I was approved to see the surgeon before they even got the approval. Jennifer

I have Tricare also and my paperwork got sent today. I am so excited. I am already checking the website to see if I am approved. hahaha My approval to see the surgeon got approved in 1 day. Then it didn't work out with that surgeon so I asked Tricare to switch me. So that approval also only took me 1 day. So I am hoping for the 1 day approvals to keep up. LOL Jennifer

I will have to be on a 2 week low carb pre-op diet before my surgery. I didn't even think to ask how many carbs were low carbs. I was wondering cause almost every veggie has carbs in it. Do I have to eat only meat? I know I should ask my surgeon. I will when I get my surgery date. I was just wondering if anyone else had to do this. I am just thankful I don't have to do 2 full weeks of a liquid diet. I think I might do that some what. Maybe liquids for breakfast and lunch then MEAT for dinner. LOL Anyway, if anyone know I would appreciate the reply....... Jennifer

I was going to post this in unsupportive spouse but he is actually TOO supportive, well if there is such a thing. I was talking to him last night about the fact that I am really scared to fail the band.(I haven't been banded yet) Well he made the comment "I'll make sure you don't fail" I thought "Aww well thanks baby", until he made his next comment. "I will keep a food log for you, for thing you can and can't have and make sure you do your excersise everyday" He is military and is very strict when it comes to certian things. I am affraid he is going to start being a drill sergeant. And if I do fail then I am affraid he will hold it against me and resent me for it. This is the only thing i am scared of. I love my hubby very much but he can be very judgmental. He does support my decision but I think he might expect me to lose all my 105 lbs I need to lose over night.... You know what I mean. I try to explain everything but he thinks he knows it all....

My PCM had to write a letter but it wasn't sent to the surgeon. I was sent to Tricare. I had to get approval from them before I could see the surgeon. Most likely because he was an off post surgeon. I am guessing. But the letter my PCM wrote and sent to Tricare must have said the right things because it got approved the next day. Now I am waiting for the surgeon's office to send my paperwork to Tricare. Jennifer

YES!!!!! I had my first appointment with the surgeon today. I already have all my lads and pre-op tests done. Except my stupid Iron test. So as soon as I get that(which is tomorrow) the surgeon's office with submit my paperwork to Tricare. OMG I can't wait.:redface: Doc said I will be scheduled this month. I can't wait. The only negative was that I had to gain 6 lbs to qualify. I needed to weight 239. Well I guess I over shot cause I weighed in today at 249. How can my scale at home be 9 lbs off. I weigh 240 on my scale at home. Well anyway, atleast I know I weigh enough. Just more I have to lose. ARGGG Jennifer

I have heard people say that if you increase you excersise you might need to increase you calorie in take. Not by alot but maybe by 100-150 calories day. If you are burning to many calories then your body does think it is starving and the scale won't move. Of course I am not an expert, I am just repeating what I have heard.

Ok, I am going through Tricare as well. I am 5'4" and weigh 249 and have hypertention. On the met life table I should be 124-138lbs. Tricare only goes by the bigger number. So in order for me to qualify I would have to be 238. I am over that. They also go by med body frame. Thats it. If you are 100 lbs over you need at least 1 co-morbity. Search tricares website and look it up. Or call tricare and ask. Thats what I had to do cause I got so many different responses from people that also have Tricare. Technically because I live in Alaska we actually have Triwest. I have never heard of Humana Tricare. I just came from North Carolina and we had Tricare North region there. But it is all still Tricare... Jennifer

Hello, I only have Tricare and my hubby is still active duty. As far as Tricare I pay nothing out of pocket. Tricare should take care of anything Aetna doesn't pay...But it might work as a re-enbersment(sp) anything military related really like re-embersment LOL

Just curious, why did you get denied? Is it because of your weight? I am just curious cause I am 5'4" and weigh 249 and have 1 comorbity. I am hoping I weigh enough. I guess I will find out next week...... Jennifer

Eric Jones: I am not sure how your insurance works but mine pays 100%. Your best bet would probably call your insurance and ask them. You have to realize that some surgeons charge any where from $7000-$25,000. So just call your insurance and ask. Maybe if you find another doc he might not charge as much.