Hi everyone, I live in the Tricare north region and am interested in LAP-BAND® surgery but do not weigh 100 pounds over my ideal weight. Has anyone with less than 100 pounds to lose been successful at getting approved by Tricare prime (or standard if it is easier to get approved) for surgery? How difficult was the process? Did you have to submit an appeal? What do you feel helped you get approved without meeting their requirements? I would really appreciate getting some input from people who have gone through this experience before me :confused:

There is a policy change coming that will mean they go by BMI. Otherwise you will need to be 100 lbs overweight with co-morbidities. Please check with your health benefits advisor for the current policy. They will be able to help you out best.

I have tricare and I only had 80 pounds to lose. They went by my BMI and co-morbidities. I had this done a year ago.

It was a super easy process. My PCM sent me a referral to the surgeon and I was pretty much in like flynn. I think I talked to my PCM in April and by June I was having surgery.