TRICARE PRIME (future lap band patient) needs HELP!
· Abbey M. · 06/11/09 07:03 PM
Thanks!!
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Abbey M.
Gastric Sleeve Patients
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:confused:hey everyone. i had a question about lap band surgery. I just left my PCM's office this morning and he has referred me to Swedish medical center for a weight loss surgery consult. I had a question about getting Triwest to pay for the surgery. I am 5'3 and a 1/2 and weigh 241lbs. my BMI is 42.4. SCARY I KNOW!! I have looked at the TRIWEST website several times and just cant figure some things out and cant get any answers from docs, tricare reps or even the surgery center where i was referred. so i logged on here and am hoping someone can help. Ok so here goes...tricare requires 100lbs over ideal weight with atleast 1 co-morbid OR 200% or more over ideal body weight. The ideal body weight for my height according to the metlife chart is 121-135. First.....do they calculate you being 200% or more over ideal weight by the first number (121) or the second number (135). Second....I do have high blood pressure which constitutes a co-morbid as well as asthma (not sure if that is a co-morbid or not). But I am not taking blood pressure meds for my high blood pressure. so my questions are those that i named and also....has anyone had experience with triwest and had a similar situation? what is the likely hood that I will get approved? if anyone can help i would greatly appreciate it!
Thanks!!