RubyTuesday

Ugh- I have a big decision to make guys and really need some suggestions!! So, I am Tricare Prime and have already been accepted into the surgery clinic at William Beaumont (woo hoo). Except there's potentially a 6 month wait. I could switch to Tricare Standard and potentially have this surgery in October. My hubby deploys in November, his family comes out in October, which would be great because then I would have someone to watch my 18 month old daughter. So anyway- Friday is my OFF POST surgical consult. I have to switch to Standard before then to be able to go. What do I do? I'm 5'5", 250 lbs if I've had a big meal, and have severe pain in knees and back, and high blood pressure, and high cholesterol. Should I just wait and go to the on post doctor, or take my chances and switch?? arghh. so stressed about this!:thumbup:

Hmm.. that's true. Our cap is 1000, but that's still 1000 bucks. I have tried the referral- Dr. Johnson is very adamant about not referring people off post- according to his nurse. Is there some way around that?? Hel, how long would the wait have been for you on post? I would be going through Dr. Lara as well. I've heard great things about him.

Hey TeeKee, this is kind of off topic, but what did they deny you for? Did you have co morbs, etc??

ahw thanks If you have any pointers that would be great too! I have tricare so that's helpful, but ANY info would be wonderful. what do you think about my chances??

Hi all! My name is Ruby and I'm pretty new to this joint. I have just begun from Lap-band journey, and am way beyond excited about the prospect about being healthy again! I have a few questions for you experienced individuals, and especially those with Tricare/Tricare Prime. Currently, my weight is fluctuating around 245, I am 5'6" and have high cholesterol, blood pressure between 137/89 (lowest) and 154/99 (highest), joint pain preventing me from exercising rigorously, and had my gallbladder removed do to cholecystitis (does that count after it's been removed??) brought on by obesity. Do these sound like co-morbids that'll qualify? Do my stats sound like a good chance of being approved? I've read the standards but want to hear -experience- hehe. And just to let yall know how early I am in this whole thing- I'm still waiting on a referral to see a surgeon. Gotta love William Beaumont and the chief of surgery taking 5 business days to review the request before sending it on to Tricare. Anywho, ANY advice/info would be awesome. Thanks and God bless! -Ruby :biggrin:

StepofFaith- I'm just beginning my process, and Tricare Prime is most likely going to refer me to Dr. Acosta (I live in El Paso). I was wondering if you could tell me what his pre-op requirements were, how long it took to schedule the surgery, how everything turned out, etc. Any info would be great! Thanks so much. -Ruby

you know, i don't know the exact details, but they both had leaks that were eventually fixed, but I remember it being a pretty big deal. and they both gained back all their weight, but i think that's a risk you always run if you aren't ready for the life style change. keep me updated!

nurse- I think the first thing you need to do is get referred to a surgeon for a consult by your Primary Care Manager. At least with Tricare Prime that's the case. Do you get to choose your own doctors and do not have to be seen on post? If that's the case, then you don't need a referral for the surgeon and can just go, and they'll submit the paper work to get it approved through Tricare. And you can always call Tricare and ask them. They're fantastic.

when looking at the met life chart, does tricare consider you a hundred pounds over weight from the low end of the range, or the high? For instance I'm 5'6" and 242 lbs. The met life chart says for med. frame, my weight range is 130-144 I believe...?

Gosh, good luck! That does sound busy. But thank goodness they're getting you in quick. The surgeon's office that I spoke to where Tricare Prime is referring people said they do everything in house. So that'll save time on appointments. I'm just dying to get my referral and get this thing started! I am going for the lapband, mostly because I have a couple family members that went with gastric bypass, and didn't have the best time with it. Plus, I have a 17 month old daughter who demands mama be available, so I don't have too much recovery time open. How come you decided on the gastric bypass? If you don't mind me asking! Again, good luck!

DeterminedWifey- Thanks so much for the info. Apparently the referral has to go through the chief of surgery before being sent to tricare?? Also, I found out that Tricare Prime is referring people off post now. Have you been assigned to a surgeon yet? I'm so happy they approved you, and good luck!

Determined- I'm in El Paso/Ft Bliss too! I just went to the PCM today and they sent in my referral. I'm 240 lbs (which puts me at 100lbs overweight for the low end range for my body type) My BMI is 39, I have high cholesterol, high BP, and severe joint pain. What do you all think about my chances?? Determined- please keep me updated on your journey, and any advice/things to do would be great!! Thanks!