FattyCakes

Hi everyone. I'm glad I found this site. I see my primary doctor on May 11th and I'm worried she won't submit a referral for me. I don't know why I have so much doubt -- I clearly qualify. Wondering how hard it is to get your doctors to agree with sending a referral. Edit: So after being on here for hours, I may not qualify as much as I thought. I'm 5'0" and weigh 214 pounds. I would say I'm small frame b/c if I squeeze REAL tight the tips of my fingers overlap. Now, I would also have to have high-blood pressure for TriWest to approve me.

Simply put: I want to be approved. I read their policy and I may not qualify, then I have people AT TriWest over the phone tell me that, you can get the lap-band on BMI too. I asked her how does she know, b/c it's not written in their policy and she said, "because I've been trained on it." I'm feeling pretty stressed... I've been trying to lose weight for 7 years only to gain it back and more. It seems like I'm putting to much hope into this. My stomach is in knots. I go to a seminar tonight and I see my primary doctor on the 11th. I just wanted to vent for a minute. Oh.... I'm 5'0" 215 pounds.... No high blood pressure, but maybe pre-hypertension.

My PCM said she would put in the request to Tricare! She gave me a really hard time about it though. It's simple to her you know... just make that change in your lifestyle is basically what she kept saying. It wasn't until the end that she said she would do it, so it was worth the hassle. I'm thankful. :scared2:

I went to a seminar on the 5th and it was very informative. They went over all three procedures. I've heard a lot of bad things from people who've gotten the bypass and it's not reversible like the band. And if you get pregnant you can keep your band in. The recovery is also faster. Oh, and a lot of people with the bypass have gained the weight back. :scared2:

That really stinks! You do your part and then they drag their heels when it's their turn!

I feel embarrassed that I want it... I told my hubby that if I got it, I'd like to keep it a secret unless I just have to tell them. I feel like I couldn't do it on my own and I was weak. :biggrin:

Oh, that is sooo great to have her support you when you thought she wouldn't. I feel the knot in my stomach every time I think about tomorrow. I asked the NP if the doctor has ever written referrals for the lap-band and she said yes. This is my first time seeing this doctor.

I've been going around saying I'm 5'1" for the last 17 years and just recently I thought about measuring myself and turns out I'm only 5'0" Wonder why your appeal would take so long since you lost two inches. What region are you in?

Thanks. I see my PCM tomorrow. She's all into healthy eating and stuff, so I'm worried she'll tell me that's the ONLY way. I know I can do it that way, I just need this small little tool to help me. Yes, waiting 6 months would stink. I hope the Naval hospital helps you out.

LOL I didn't even notice.

Thanks for the info. I go on Tuesday. Do you have to pay anything?

Thanks for answering that. Don't you need a referral fm your PCM to see the surgeon though?

Really, really, I guess! :thumbup: Do you mind if I ask a few questions?? If so, just ignore. lol How tall are you and how much do you weigh? How did you go about the process? I thought I had to see my primary and she would put in the letter, not the surgeon...??? :thumbup:

I called TriWest today b/c my friend told me that they'd approve me on BMI alone. The lady read out-loud just what I read on their web-site (with no mention of BMI) and I mentioned BMI and she said, yes you can get approved on BMI too. I asked her how she knew that and she said she's been trained on it. I told her I was scared that if I called back that someone else would say no..... So, it's not written in their policy that I know of, she's "just been trained." :thumbdown:

I know, it doesn't. I think they are in the process of revising their policy or that's what I got from reading other posts last night. I went to Rite Aid and did the little blood pressure test, and it said I was only 124 over something... I don't remember, so that means I don't have high blood pressure.

I guess Tricare doesn't go by BMI. You have to be 100 pounds overweight and have.... one of the following diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome, hypothalamic disorders or severe arthritis of the weight-bearing joints. Hypertension may be the only one I have. I'm going to a seminar on the 5th, maybe they'll help me get accepted....

I've seen a lot of success stories, and the pain seems worth it I think. :thumbup:

Thank you! It's become more about my health since hitting my 30's. Good job on your weight-loss so far!

I have TriCare, so I have to. :thumbup:

Thank you for that little reminder!

Thank you for sharing this!

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