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Anyone have Tricare Insurance?

Has anyone out there gotten Tricare (the military insurance) to pay for Lap Banding? Any info you have is greatly appreciated! Thanks,

Pattie

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My daughter has Tricare and was approved for gastric bypass surgery, but NOT lap banding. She went for it and had the gastric bypass. All I can tell you is they will cover it eventually if you can wait that long. I personally want no part of gastric bypass.

Hi, i use to work for tricare North region. All regions are the same, tricare will cover the lap-band at MTF. But if your have tricare standard or extra u can go to an outside doctor for lap=band but your going to have a lot of paperwork to do just to get them to pay. (the most you'll pay is $728 for the whole surgery) but if you have tricare prime you will have to have 2 medical condition and 100lb over your normal weight and military pcm to referral for the lap-band. everytime you call tricare you'll get a different answer.Best advance check website tricare.osd.mil type: morbid obesity in search box

Tricare is good. They also give you one plastic surgery down the road and my daugher is cramming everyting she can think of into that one surgery. I think all insurance companies should offer it. What a boost it would be for moral.

  • 1 month later...
  • 4 weeks later...

This is great to hear. I think I am going to call the office and set up an appt and find out what the next step is. :cake:

How are some of you getting it covered? It's not a covered procedure at all. Except at an MTF and I have only found 2 in the country that do it. Both not in my region so I couldn't go there. And to the woman that said go to the website and search it, no where on it does it say its covered at all. Vertical gastic banding is not the same thing as lapband. Can someone help me understand how you got it covered and where in the last 12 months since that is the basic timeline that they would no longer cover it? I just cash paid last month for it, because i was so againest me have gastric bypass.

I didn't do anything, actually. The doctor's office submitted the papers, but Tri-Care told them (they said) that it didn't need pre-approval. So I can't really help you :)

No, I have Standard. And I didn't get a PCM until after I'd already seen the surgeon, although I did see one before they submitted the paperwork.

There were lots of people involved in my surgery per se. 2 surgeons, my PCM, nutrionist, psychologist, etc. It's a regular program they have here, and it's great. Once I'd been through the hoops, they submitted the paperwork.

  • 1 month later...
Hi I am new to the forum, I was wondering what was the name of your surgeon, Jil?

It's in my sig :) Don't ask me to spell it again - once was hard enough :)

  • 2 weeks later...

This thread has gotten me so baffled. I too cannot get Tricare to even think about paying for the lap-band. I know any day now they may cover it because Medicare now covers it, but I just called 5 minutes ago and thy DO NOT cover it.

Just this morning I checked mytricare.com and my referral to see a WL surgeon has been approved. The funny thing is it is for a Dr that only does Lap Band. Until today I had never considered a Lap Band and I don't know much about it. I can not call the Dr or TRICARE until Monday so I am trying to research as much as I can

I have TRICARE PRIME REMOTE, I am wondering if this means they are going to start paying for Lap Band????

Tricare is good. They also give you one plastic surgery down the road and my daugher is cramming everyting she can think of into that one surgery. I think all insurance companies should offer it. What a boost it would be for moral.

I just found this site and I do not want to come off sounding like a snot, but this is just not true.

TRICARE will, in some instances, pay for some plastic surgery. But only when medically necessary, like when you have a hernia or need a breast reduction. The idea that TRICARE automatically gives everyone one free shot at all the plastic surgery you can fit in is very misleading. I wish it were true, but it's just not.

Again I apologize because it does sound like I am being a snot and I really don't want to.

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