DaniKLargo

I googled this last week, and I found a change dated 6/30/2006 labeled "Transmittal #94" with a whole bunch of other codes and stuff on it. It says the Lapband procedure is now covered. I showed it to the doc at the base clinic and he looked into it, talked to the Tricare office, and agreed. Here's the kicker - every facility is setting it's own guidelines for approving the procedure (per the LCDR I just spoke to). I'm at the mercy of the Jacksonville Naval Hospital, and apparently they require that I go through a 6-month weight-loss program supervised by the local (Key West) base docs. Now, I can see where this is going. I know I will lose 20-maybe 30 pounds. Then I will be downgraded from morbidly obese to grossly obese and no longer qualify for the surgery. They will pat themselves on the back, I will gain the weight back, which I always do, and then we will transfer next summer and I will no longer be their problem. Aaaaarrrrgggggghhhhhhhh!!!!!!!!!!!!

I've started the Tricare Prime process, but if it gets denied, I'm wondering if I switch to Tricare standard it would be easier? I know I'd pay out of pocket some, but I could manage that. Does anyone know?

Thanks so much for this thread. Two days ago I consulted with the Tricare Prime doc at the Navy Hospital and surprisingly he was very helpful. He seemed supportive, which I NEVER get there. He actually read the stuff I had printed out about Tricare and the procedure, and he researched it while I waited, then said I need to meet with a dietitian and some other specialists to meet the Tricare requirements. I'm trying not to get my hopes up, considering what I've just read in this thread. I hope people will keep posting - I'd really appreciate any info about the Tricare experience.