Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Hoping to get a "yes" answer.



Recommended Posts

Tricare doesn't make sense. But for those of us who have it, we deal with it. And yes, they are in the process of changing their policy but as with any federal program, who knows when it will take effect. I am 100 pounds overweight with no co-morbidities and am currently waiting on my appeal. I was not measured at my surgeon's office since they have never had to deal with this policy before. They took my word that I was 5" 3" (as have every doctor I've seen in the past 25 years). I was just remeasured at a military medical clinic and found to be 5" 1". That puts me well within Tricare's standards for "morbidly obese" (meaning I qualify) but now I have to wait for the appeal. And yes, they frustrate me (as if you couldn't tell). If you have concerns, talk to your PCM, your surgeon and your Tricare specialist. They will help you out.

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?

Share this post


Link to post
Share on other sites

I had the same fear that my pcp would not recommend the surgery for me. Took a lot of guts to bring it up with her on my part. She never seemed concerned about my weight and one time, years ago, I inquired about Meridia and she gave me a very condesending talk about "taking in fewer calories than I burn." :biggrin: (Oh really? Is THAT how it works?) I was bracing for a very direct conversation with her about everything and to my surprise, she could not have been more supportive :lol: We talked at length about the surgery and she felt it was very safe (as far as surgery goes) and said she has several patients who have done it and acheived excellent results. She had my letter ready that day and it was extremely well-written and supportive. I hope you get pleasantly surprised, too! As for your insurance - I hope that goes your way as well. Sounds like they are a little behind the times with their requirements...

Share this post


Link to post
Share on other sites

I had the same fear that my pcp would not recommend the surgery for me. Took a lot of guts to bring it up with her on my part. She never seemed concerned about my weight and one time, years ago, I inquired about Meridia and she gave me a very condesending talk about "taking in fewer calories than I burn." :biggrin: (Oh really? Is THAT how it works?) I was bracing for a very direct conversation with her about everything and to my surprise, she could not have been more supportive :lol: We talked at length about the surgery and she felt it was very safe (as far as surgery goes) and said she has several patients who have done it and acheived excellent results. She had my letter ready that day and it was extremely well-written and supportive. I hope you get pleasantly surprised, too! As for your insurance - I hope that goes your way as well. Sounds like they are a little behind the times with their requirements...

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.

Share this post


Link to post
Share on other sites

Hi, I'm Karen, 47, from Texas. My insurance gave a cursory approval - I had pre surgery objectives to meet. one of those being 3 months of diet and exercise. I have completed all of those and am now just waiting for insurance approval that I've met all my criteria so I can set a surgery date. It has been 2 weeks since my info has been submitted and this is a very frustrating time just hoping that I can get my band and start my new life.

Share this post


Link to post
Share on other sites

Hi, I'm Karen, 47, from Texas. My insurance gave a cursory approval - I had pre surgery objectives to meet. one of those being 3 months of diet and exercise. I have completed all of those and am now just waiting for insurance approval that I've met all my criteria so I can set a surgery date. It has been 2 weeks since my info has been submitted and this is a very frustrating time just hoping that I can get my band and start my new life.

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

Share this post


Link to post
Share on other sites

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 think going in there like you're taking charge of an out of control situation (we all know the definition of insanity by now) and letting the doc see how informed you are about the procedure and process will help a lot. Doc's don't want patients who think they are getting a magic band that will automatically cure them. It's only a tool, and it only works if we choose to use it. You'll do great!!!! Let us all know how it goes. In the off-chance it doesn't go well...your surgeon can recommend a pcp who will be more symphathetic :biggrin:

Share this post


Link to post
Share on other sites

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.

I went to one doctor before the one that referred me. She was like that too. It was weird, I thought that she would have been more towards me getting it done too. She said that she comes from a family that is obese too, and look at her. She said she has to try hard everyday to look the way she does, and all it takes is will power. That is great if that is what you are able to do. I need something to help me too just like you. I hope I can get as much information as I can from this orientation on thursday.

I have a question for all of you out there, what made you go for the lap band, and not the gastric bypass? My mom did the gastric bypass three years ago and she looks amazing, my sister did the band two years ago, but now she is pregnant. What are your views on pregnancy after getting banded?

I have so many questions, I just don't know where to start.

Stayce

Share this post


Link to post
Share on other sites

I'm in Tricare North. They have received my appeal and will hopefully hear something by the end of the week or beginning next.

Share this post


Link to post
Share on other sites

I went to one doctor before the one that referred me. She was like that too. It was weird, I thought that she would have been more towards me getting it done too. She said that she comes from a family that is obese too, and look at her. She said she has to try hard everyday to look the way she does, and all it takes is will power. That is great if that is what you are able to do. I need something to help me too just like you. I hope I can get as much information as I can from this orientation on thursday.

I have a question for all of you out there, what made you go for the LAP-BAND®, and not the gastric bypass? My mom did the gastric bypass three years ago and she looks amazing, my sister did the band two years ago, but now she is pregnant. What are your views on pregnancy after getting banded?

I have so many questions, I just don't know where to start.

Stayce

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:

Share this post


Link to post
Share on other sites

I'm in Tricare North. They have received my appeal and will hopefully hear something by the end of the week or beginning next.

That is great, I wish you the best of luck!!

Share this post


Link to post
Share on other sites

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:

My mom went from almost 400 lbs, to now 150 lbs. She looks amazing. The reason I am going towards the band is because it is a much slower way, I can exercise to get skin to tighten back up. My mom has extra skin because she lost weight so fast.

I want this so much that I would love for it to happen tomorrow, but I know that is not going to happen. I know there are tests that have to be ran and all of that, I just wish it was done and over with and I could start over. Ready for a new life, healthier life, and a happy life!!

Share this post


Link to post
Share on other sites

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:

Share this post


Link to post
Share on other sites

That is great!!!! I am so excited for you!! Maybe we will be doing it right around the same time!!! I wish you luck!!!:)

Share this post


Link to post
Share on other sites

I'm going in for a physical on December 8th, I'm going to talk to my PC doctor about getting the lap-band, I brought it up a few months ago and

she didn't gave me a positive answer, she put me in the Mediterranean diet, I have try many diets, I do good for about 3 days and that's it, one time i did well for a month but went right back to eating a lot, if i'm sad i eat, if i'm happy i eat, I'm just tired of wasting my time and having so many let downs, wish me luck, I'm 5 1, 196 pounds female, and I have Blue Shield of California, does anybody know if i need to have a referral from my pc or should i talk directly with a doctor that performs the lap-band surgery?

Share this post


Link to post
Share on other sites

Thanks for the info. I have Tricare also and was turned down once. I appealed and waiting on the results. Everyone please keep me in your prayers that this goes well and I get approved.

Tricare doesn't make sense. But for those of us who have it, we deal with it. And yes, they are in the process of changing their policy but as with any federal program, who knows when it will take effect. I am 100 pounds overweight with no co-morbidities and am currently waiting on my appeal. I was not measured at my surgeon's office since they have never had to deal with this policy before. They took my word that I was 5" 3" (as have every doctor I've seen in the past 25 years). I was just remeasured at a military medical clinic and found to be 5" 1". That puts me well within Tricare's standards for "morbidly obese" (meaning I qualify) but now I have to wait for the appeal. And yes, they frustrate me (as if you couldn't tell). If you have concerns, talk to your PCM, your surgeon and your Tricare specialist. They will help you out.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 0 replies
      1. This update has no replies.
    • Mr.Kantos

      Just signed up. Feeling optimistic.
      · 0 replies
      1. This update has no replies.
    • Frugal

      Welcome to Frugal Testing, where we are committed to revolutionizing the software testing landscape with our efficient and affordable solutions. As a pioneering company in this field, we understand the challenges faced by startups, small to medium-sized businesses and any organization working without budget constraints. Our mission is to deliver top-notch testing services that ensure the highest quality of software, all while keeping your costs in check.
      Frugal Testing offers a comprehensive suite of testing services tailored to meet diverse needs. Specializing in different types of testing including functional testing, automation testing, metaverse testing and D365 testing, we cover all bases to guarantee thorough software quality assurance. Our approach is not just about identifying bugs; it's about ensuring a seamless and superior user experience.
      Innovation is at the heart of what we do. By integrating the latest tools and technologies, many of which are cutting-edge open source solutions, we stay ahead in delivering efficient and effective testing services. This approach allows us to provide exceptional quality testing without the high costs typically associated with advanced testing methodologies.
      Understanding each client's unique needs is fundamental to our service delivery. At Frugal Testing, the focus is on creating customized testing strategies that align with specific business goals and budget requirements. This client-centric approach ensures that every testing solution is not only effective but also fully aligned with the client's objectives.
      Our team is our greatest asset. Composed of skilled professionals who are experts in the latest testing techniques and technologies, they bring dedication, expertise and a commitment to excellence in every project. This expertise ensures that our client’s software not only meets but often exceeds the highest standards of quality and performance.
      Frugal Testing is more than just a service provider; we are a partner in your success. With a blend of quality, innovation and cost-effectiveness, we are here to help you navigate the complexities of software testing, ensuring your product stands out in today's competitive market. 
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×