Military Wives Who Have Had This Surgery

[MrsMoretti 0]

Hello I Have Tri Care Prime and I dont see many people on here actually talk about what the standards are as far as BMI goes and Hight and Weight, For example Im in the process right now waiting to have my paperwork submitted to tri care but i dont know if i will be approved im my bmi is 39.8, Im wondering if anyone had any problems getting approved with a BMI like mine.... I also have Joint pain and depression? please help !

[lovemysgt 4]

I AM A ARMY WIFE WITH TRICARE PRIME ALSO AND I WENT THROUGH THE PROCESS FAST ALSO. IT ONLY TOOK A LITTLE OVER A MONTH TO GET EVERYTHING DONE EVEN THE SURGERY.

OK MILITARY WIVES AND HUSBANDS WHERE ARE ALL YOU STATIONED SO MAYBE IF WE ARE NEAR EACH OTHER WE CAN VISIT AND HELP EACH OTHER IN PERSON.

I AM STATIONED HERE AT FT HOOD, TEXAS

[lovemysgt 4]

I AM GUESSING YOU DON'T HAVE TRICARE PRIME? I HAVE TRICARE PRIME AND IT PAID FOR EVERYTHING INCLUDING THE PSYCH EVAL

I am a military wife with tricare as well. I started my process at the beginning of January of 2009. MY PCM put in the referral for me, it was approved within 3 days. I contacted the surgeon, then had to wait 3 weeks for the next seminar. Then I had to wait again for the surgeon's office to call me to make an appt. I got all my pre-op testing done, more waiting on the surgeon to get everything to Tricare. Once they sent it in, it only took 2 days to get approved. i had my surgery on March 27, 2009. So, all together the process to about 3 1/2 months. Tricare paid for everything except the $250 required by my surgeon for a pysch consult. Tricare has paid for all of aftercare. I do need to get a referral every 3 months from my PCM, but she likes to check in on things anyway so it works out okay.

Overall I am very happy with Tricare and their coverage of the LAP-BAND® and aftercare. I am hoping they will be just as willing to cover the removal of some excess skin. From what I've heard it all depends on your PCM and if they want to fight for you. Hopefully I get to find out soon!

[lovemysgt 4]

OH I AM NOT SURE MINE WAS AT 40.1 BMI. IF I CAN REMEMBER I THINK IT WAS 39 BMI AND YOU HAD TO HAVE ANOTHER PROBLEM LIKE HIGH BLOOD PRESSURE OR SOME OTHER PROBLEMS. I DON'T THINK THEY WILL HAVE A PROBLEM WITH YOUR BMI IF THEY DO THEY WILL JUST MAKE U GAIN A POUND LOL

Hello I Have Tri Care Prime and I dont see many people on here actually talk about what the standards are as far as BMI goes and Hight and Weight, For example Im in the process right now waiting to have my paperwork submitted to tri care but i dont know if i will be approved im my bmi is 39.8, Im wondering if anyone had any problems getting approved with a BMI like mine.... I also have Joint pain and depression? please help !

[kellyjoiii 19]

I too am a military wife, Navy (Husband 22 years) and utilized Tricare for my surgery. My BMI was 39.8 but I also had HBP (comorbidities included HBP, DX'd sleep apnea or DIABETES -not prediabetes) but that may have changed. It took me about three months from start to finish for seminar, first consult, psych eval, and nutritionist. My dr is 3.5 hours away, (I live in Key West) and am just now going on a year-tomorrow. I am down 83.5 lbs, and would do it again in a heart beat. I told my husband that I would put money aside, incase tricare would not pay if something happened to my band. I love my band. It is finicky sometimes but again fivefold I would do it over. The only out of pocket I paid was for the nutritionist (utilized military onesourse for the psych eval). I know of a few women here who have had it done....and many more trying. They are putting a little damper here because so many people have expressed an interest in having it done (referrals) so I heard it was a little harder now. It's worth the effort that you have to put into it though, 63,000 surgery for 150, healthier lifestyle, no meds for bp and a better self confidence? Totally worth it.

OH I AM NOT SURE MINE WAS AT 40.1 BMI. IF I CAN REMEMBER I THINK IT WAS 39 BMI AND YOU HAD TO HAVE ANOTHER PROBLEM LIKE HIGH BLOOD PRESSURE OR SOME OTHER PROBLEMS. I DON'T THINK THEY WILL HAVE A PROBLEM WITH YOUR BMI IF THEY DO THEY WILL JUST MAKE U GAIN A POUND LOL

[ShrinkyDinkyDoo 2]

Hi, I am an Army wife, and I live 90 miles from the closest base (Ft. Sam Houston, San Antonio, TX) My hubby is in Afghanistan, so I moved home to live by family. I used "True Results" and they can tell you exactly where to find a surgeon that takes TriCare. I went to my seminar in January, and had my band on Apr. 12th. TriCare wasnt the reason it took so long, I had issues with the referal lady at my PCM's office who didnt know the TriCare system and kept submiting my referal wrong. But I actually had my first meeting with my surgeon at the begining of March, and like I said, was banded in April, so its a quick process. Right now, TriCare requires that you weigh at least 100lbs over the medium frame build (they use medium frame for everyone, unless you are really short, then maybe you can ask them to go off of the small frame)(underneath my weight, im a big person, 5'10", so I was worried I woulnt make the weight, but my surgeon said that Tricare uses the "medium frame" for everybody) on the Met Life scale, and have at least one co-morbidity, I have high blood pressure, but it wasnt documented anywhere in my medical charts as being a problem, my PCM just went back through them and verfied that it is usually high (145/90 usually) I also have high cholesterol) If you have no co-morbidities, then you have to be 200lbs over weight. I think the thing that really helped me was a good referal from my PCM. If he hadnt looked back through my charts and noticed that I do have these co morbidities, I never would have qualified.

I had a big problem with on base care. My base PCM was a very large woman (bigger than me) and when I asked her if I could qualify for something like the Lap Band, she didnt even hesitate to tell me NO!! She didnt look at my records, she just told me I didnt qualify, and needed to lose the weight on my own. How Rude!! I did qualify! Going off of the base was a really good experience for me. My surgeon was kind of a male Diva, who doesnt do his own follow ups, and never checked in with me, but his office made up for that. I have been pampered and spoiled by everyone there, and I feel like part of the family. When I asked them if they could rush this so I would be healed by the time my hubby came home for R&R, they did. My surgeon even scheduled me at 7 at night, and stayed late, and put me on the end of his long day, just to help me out! AWESOMENESS!! I was approved on Monday April 11th at noon, and had the surgery Tuesday Apr 12th.

This has been a great experience for me. Its a total learning process, and something new everyday, but its the best decision I have ever made and would make it again in a heart beat!!

[MrsMoretti 0]

my bmi i think is like a 39.3 or something Im praying i dont have to appeal it because they deny me.... that would SUCK!!! if you do appeal it and u gain a few more pounds do you have to go through the process all over again??? like seeing all the DR'S?? please help if you know anything thanks....

shayna

I too am a military wife, Navy (Husband 22 years) and utilized Tricare for my surgery. My BMI was 39.8 but I also had HBP (comorbidities included HBP, DX'd sleep apnea or DIABETES -not prediabetes) but that may have changed. It took me about three months from start to finish for seminar, first consult, psych eval, and nutritionist. My dr is 3.5 hours away, (I live in Key West) and am just now going on a year-tomorrow. I am down 83.5 lbs, and would do it again in a heart beat. I told my husband that I would put money aside, incase tricare would not pay if something happened to my band. I love my band. It is finicky sometimes but again fivefold I would do it over. The only out of pocket I paid was for the nutritionist (utilized military onesourse for the psych eval). I know of a few women here who have had it done....and many more trying. They are putting a little damper here because so many people have expressed an interest in having it done (referrals) so I heard it was a little harder now. It's worth the effort that you have to put into it though, 63,000 surgery for 150, healthier lifestyle, no meds for bp and a better self confidence? Totally worth it.

[lauragshsu 6]

I'm an Air Force wife, and was banded 3/15/2010. I didn't have any comorbidities (although have PCOS), but did have a family history of diabetes, high blood pressure and high cholesterol. I also had a high BMI. I had my initial referral for the surgery Norvember 25 (my 28th bday) and it took me until March 15th for the surgery. Everything was easy but the psychological evaluation. Tricare kept me referring me to the wrong people.

I also had to have two revisional surgeries- my first incision never healed, even after 7 months, and I got a port infection. The port had to be removed (October) and they let me heal a bit/let the infection clear before putting a new port in (November).

Tricare has paid for it all- fills, flouroscopies, revisional surgeries- probably more than $40K.

The end result? 122lbs lost and the abilitiy to get pregnant!

[lovemysgt 4]

CONGRATZ TO YOU I HAVE PCOS AND I FOUND OUT TOO LATE AND WASN'T EVER ABLE TO HAVE KIDS I TRIED INTRO AND FAILED AND TRICARE WOULDN'T PAY FOR IT SO 10 GRAND ON A FAILED INVITRO I AM NOW TOO OLD FOR INVITRO SO IJUST GAVE UP ON ANYTHING DEALING WITH KIDS. I HAVE MY FALLOPIAN TUBES OUT SO THERE IS NO WAY EVEN GETTING PREGNAUT.

I'm an Air Force wife, and was banded 3/15/2010. I didn't have any comorbidities (although have PCOS), but did have a family history of diabetes, high blood pressure and high cholesterol. I also had a high BMI. I had my initial referral for the surgery Norvember 25 (my 28th bday) and it took me until March 15th for the surgery. Everything was easy but the psychological evaluation. Tricare kept me referring me to the wrong people.

I also had to have two revisional surgeries- my first incision never healed, even after 7 months, and I got a port infection. The port had to be removed (October) and they let me heal a bit/let the infection clear before putting a new port in (November).

Tricare has paid for it all- fills, flouroscopies, revisional surgeries- probably more than $40K.

The end result? 122lbs lost and the abilitiy to get pregnant!

[MrsMoretti 0]

well wish me luck ..... they should be submitting my paperwork very soon