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TRICARE Questions!!



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I have been looking into the lap-band for 6 months now. We were going to have to pay out of pocket for it because our insurance wouldn't cover it so I had pretty much given up. My husband just recently joined the Army. We will not be registered for TriCare benefits until January, but I had some questions. I've read on the TriCare website that it does in fact cover lap-band. Also that I qualify due to my height (5'0''), weight (215) and BMI (42). My question was about the financial end. Do they cover all of it? Or are you expected to pay some? It is definately something I am interested in and would like to financially prepare for it if I can. Thank you for all your help!! I'm getting excited about hopefully finally being able to get it done!

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You will probably get a variety of answers, as there are different kinds of Tricare; I also have a sneaking suspicion that sometimes it depends on what Tricare representative processes the billing and how they interpret coverage, as I have read on here so many people being told (and charged) differently. I have Tricare Reserve Select, which is similar in most ways to Tricare Standard. I had to pay a few copays, as well as cover about $600 of the surgery to meet my catastrophic cap, after which Tricare covered the rest.

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Tricare will cover the entire cost if you have it done at a Military Treatment Facility. Is your husband going active duty or reserves? My husband too is in the Army so we have Tricare Prime and I had my Lap-Band done at Madigan Army Medical Center here at Ft. Lewis. I have never paid one cent to Tricare for either the procedure or any fills that have followed. Granted I do live on Ft. Lewis so I automatically have all my care done at the MTF. I don't have any personal experience with dealing with Tricare but I have seen alot of posts about it being kind of a pain in the ass to get Tricare to approve. Best of luck to you in your journey:thumbup:

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He is active duty. He'll be shipped off for basic in January so I'm still unsure about how it will all pan out. We'll find out about the beginning of May where we will be stationed. I have also read other posts and it does seem like a lot of people have trouble with Tricare. It's very comforting knowing that you had no problems and didn't have to pay anything. There's HOPE! LoL... I hope I'm lucky enough to not have any problems either!

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I have Tricare Prime, and we don't live near a MTF. I paid $25 for the hospital. I paid $75 for my nutritional consult and $150 for my psych eval. I know that I could have had those 2 things completely covered if I would have wanted to hunt for somebody that took Tricare, but I figured it would be easier on me to just suck it up and pay $225 to use the people in his office. Every thing else was completely covered. I went to my PCP, and he referred me to a Lap-band surgeon. The entire process took less than a month from the time I went to the doctor till the time I had my surgery.

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I have Prime too and didnt have to use MTF and havent paid a dime. Good luck with your journey =)

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Your best bet, once your husband has gone through basic, is to contact your Tricare representative. He/she will be the best one to speak with as their have been changes (or are going to be changes real soon) to the plan.

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