katwmn63

if this isn't getting too crazy for you, would you forward one to me via email? katwmn63@yahoo.com

..wel i had the appt w/my pcp and to my surprise he was all for me having the procedure!:grouphug: He even asked if i needed a referral letter, that he'd be happy to write one. So i decided to wait to hear back from my surgeon and agreed I will call him (PCP) if I need one. that went soooo much better than I imagined. now.... if only the insurance company cooperates so well :l

3 down and 1 to go! Esophagram and nutrition consult done on June 4, psych this morning... all went well. Now this afternoon at 2pm i have an appt with my PCP. I have no idea what to ask of him, and I can't reach my surgeon's office (which is unusual...they are normally very availale and quick to answer questions). My surgeon's coordinator told me to get the espohagram, nutrition and psych, but never really mentioned a letter from my pcp. But have seen threads on here that mention requiring it, plus he has followed me medically for so many years, i just made the appt assuming i should. Does anyone with tricare even need a pcp letter (other than for the initial referral to the surgeon)? Does anyone think I should have him write me a letter just in case? If so... what should it say? He is a very conservative man....hmmmm:glare:

Hi 2000 hope: I have a BMI of 40.1 and am 100 pounds over my ideal weight. i also have a comorbid of arthritis and i am applying through Tricare. Let's compare the responses we get. They should be darn close:) hope you keep my posted!

Do you mind my asking why your insurance denied you? I think it is awful when one has to self pay who needs the procedure.

I'm not in orlando area but a piece of advice would be to see if your surgeon is considered/holds title of "Center of Excellence". This is a gauge some insurance companies use, but even with you being self pay, it helps distinguish the quality of the surgeons/clinics. this forum is a WONDERFUL place to get feedack... you are in the right place! Good Lck!

39andholding... WTG - YOU ARE AWESOME!! Thanks for thinking of us :blushing:

I am 5'3" and 227. This puts me at 40.2 BMI. Similar or close to you!?!? My insurance requires a co-morbid even being over 40 BMI...but many don't. I have a few co-morbids so I think I'll get approved. You and I will do great! We don't HAVE to be 250-350-450 to qualify... we have to be unhealthy and unhappy and ready to make a change!! good luck!!

as far as i know... vitamin D is useful in the body absorbing calcium. could it be that you have been on a pre-op diet and therefore your vitamin D is low? either way, i do not see this as delaying your surgery. nothing the doctor wrote in the letter seemed to allude to that either. i wish you the best:)

explainl to him that if you don't learn to do it yourself...for yourself...including making your own mistakes to learn from, that you will fail. "what will i learn honey if you do it all for me"? tell him to fight his battle (protecting the U.S.) and you'll fight yours. good luck !!

Thank you so much! You also are great support...and I sincerely thank you!!!

Ideere, You are brave as evidenced by taking this huge WLS step. Your bravery will carry you even further. ((BIG HUG ))

took your advice and just checked. YES he is a "Center of Excellence" whew!

Thanks Restless... you've helped me a few times now and I really appreciate it!!!!! :biggrin:

Can anyone tell me what exactly has to be in the letter from my PCP for Tricare? I assume they require one, so I made an appt for Monday. BMI is 40.2, I am 100 lbs over ideal weight, my only documented comorbid is arthritis...but if i need a sleep study i will...i know i have apnea. I have NUMEROUS documented, medicaly supervised attempts of weight loss over the years. successful completion of esophagram and nutritionist today. psych eval before my pcp appt monday. For some reason...though i really don't know... i think my doc is kind of conservative. he is very kind, our boys go to school together, and we have discussed my weight several times. Just wondering what I need to ask him to write.?.?:biggrin: any input would be wonderful!! Thanks!

what was your BMI and comorbids?

my paperwork will likely be submitted by the end of next week to Tricare. I am sending lots of positive thoughts your way and would love it if you let us all know when you hear back. :redface: btw.. whomever your boss is...she should stuff a sock in it! she doesn't know what she is talking about and has ZERO control over Tricare's decisions.

UPDATE: My husband and I were doing alot of yardwork with the kids...I was in agony. My joints my feet, etc. When we all came in the house I sat sweating, breathing heavy and finaly I started to cry. I couldn't help it. He asked if I was gonna be ok and I spilled!!! I told him I was in pain, and for the first time ever, I spilled how much I REALLY weigh and how often I hurt. He was shocked to hear my real weight and my true condition!!!! The kid's mouths dropped open too. I took this opportunity to talk about the procedure and the steps I have already taken. I am so glad I did. My husband realizes I need to do something and supports my decision now. One of the previous posts here shared wth me the 2% success rate of those in my condition without WLS...he did not like those odds. This feels good and right and I am more ready than ever now! You are all wonderful and I thank you.

Thank you all for your info. You have helped a great deal. The only other question is... did anyone have any difficulty getting a letter of medical necessity from their PCP? With Tricare/military health care and never seeing the same doc, this can be difficult I would imagine. Again my thanks!!

a couple quick things come to mind: - shop around. even when you consider travel costs, you may be able to find it much cheaper....in fact i am sure of it. -do you own a car or anything of value where you could qualify for a secured loan? bad credit is less of a factor for lines that are secured by some kind of valuable collateral. - are you employable? work toward independace from your parents while at the same tme finding employment that offers quality healthcare benefits. You will have a grace period, but it's a start. -is there another family member or friend that your parents trust that might see your side and help sit down and educate them? Maybe they need to hear it from another professional, older, adult. I wish you the best of luck!!!!!!!!!!!

Thank you Ann!

could you tell me of any potential issues i may have with tricare? I am applying throufg them now. Thanks for any info you can give me. GOOD LUCK TO YOU!!!

I have tricare insurance. My surgeon received the "paperwork" from Tricare and has scheduled my esophagram, psych, nutrition ... all this week. I know they want info regarding previous attempts at weight loss ad comorbidities if any (arthritis, and narcolepsy that i am not getting tx for, is all I have) and I have already collected all that. I have had several medicaly supervised attempts at weight loss which is documented. In fact, I have continued to gain. My current BM is 41. I am hoping someone can give me any info on how easy/difficult Tricare is to work with. So far the only person I found on here who used Tricare was easily approved but she was much larger...she assumes that is why there was no difficlty for her. I would appreciate any info. I'm so ready and motivated, but so afraid the rug will be pulled out from under me. Thanks!

This is something I must do for me... with or without his support. I feel better knowing I am not alone in this ...that others have experienced this with their spouses. I feel even better knowing that many of you met this challenge with success. I will too. THANK YOU ALL!!!

This is something I will definately try...and I know just the person. Thank You!!