TRICARE PRIME PATIENTS

[Adrea 0]

hi, im from camp lejeune and go on wed to see my surgeon for a surgery date

YAY!! Are you going to Morehead City?

[crystalmarble00 1]

I am waiting for my referral to go through and then I will schedule an appointment with the surgeon. I want to know of anyone who got approved for surgery with a BMI of 40 or lower and what comorbs or problems you had that helped you get approved. I think my BMI is just 40 but I do not have any of tricares comorbs that are listed.

I have Hypothyroidism but no other issues and had a bmi of 49 and since Hypothyroidism doesn't count, I had to gain weight to make it to a 50 bmi before tricare would approve the surgery.

[cruse0609 0]

I have tricare prime and and having lap band done as well i was wondering what all did you have to go through to get to the surgery point

[Julieannas_Mommy 0]

Tricare approved me without hesitation. I have a BMI of 48.9 but I also have several health problems. To my understanding though, Tricare requires you have a BMI of at least 40 or be at least 100 pounds over your ideal weight (not the weight you think you should be at but what the doctor considers healthy). However, if you match that and do have some of their health problems listed, it'll make it much easier! My process started last month and Im scheduled for surgery on February 11th! Good luck ladies and gents!

Tricare does require a psych eval and nutrition eval and possibly some other tests if you havent had them recently such as a sleep study.

Im also from Dover, DE stationed at Dover AFB. My husband is active duty air force!

[Meloveme 1]

I am in the Tricare South region and will be banded on March 7. So excited. My Doctor submitted a letter of medical necessity and was approved in 2 days. :thumbup:

Cheers :cheers2:

[beaner5522 0]

YAY!! Are you going to Morehead City?

no i am going to greenville dr nazari, he is awesome

[Perk25 0]

no i am going to greenville dr nazari, he is awesome

I am going to Dr Bell I haven't met him yet. I am going to a seminar on Feb 14 then I can make my appointment to meet with the surgeon

[aNEW_me2011 0]

I"m also Tricare South! I had my PCM send in for the approval. Tricare approved it that day! Did my psych visit and my advocate recieved it by fax and the next she called me with the approval So they work pretty fast in the South Region i guess! Anyone in Texas getting it done?

[doodlebugsmom 9]

I"m also Tricare South! I had my PCM send in for the approval. Tricare approved it that day! Did my psych visit and my advocate recieved it by fax and the next she called me with the approval So they work pretty fast in the South Region i guess! Anyone in Texas getting it done?

I am in Texas-the Fort Worth area. Nice to meet you! I am hopeful to finish the pre-op stuff and have surgery around March 10 so that I have all of the spring break to heal.

My doctor mentioned that Tricare changes is mind dailey on whether or not you have to stay the night following surgery. Anyone else hear this?

[Perk25 0]

sounds like i need to head further south

[USMC Wife 1]

That's awesome! I am South Prime (Florida) as well and was approved quickly. Submitted on Friday, approved on Monday. I had my surgery on January 27 and looking forward to my new life

I am in the Tricare South region and will be banded on March 7. So excited. My Doctor submitted a letter of medical necessity and was approved in 2 days. :thumbup:

Cheers :cheers2:

[Cocoabean 430]

Hi,

I am in process of trying to get my BMI to 35. I have type 2 diabeties,HC,HBP. I am having to gain 10pds to reach 35bmi even though Tricare isn''t requiring it? The surgeon is the one requiring the BMI 35.

Has anyone had to gain to get approval? I am Tricare Standard retired living in VA.

Does the surgeon require you to have been BMI 35 or over for any length of time? This is a new one on me, that the insurance doesn't require it, but the surgeon does. I am not well versed in Tricare at all.

But you might point out to the surgeon (if this is true) that you have gaind xx pounds each year and it is just a matter of time until you get there. Does he know you are purposely gaining to qualify? If so, he should understand the problems associated with yo-yo dieting. There is also a study going on (I think it has begun) to lower the suggested BMI and comorbidites for use of a band.

I believe also, that if it is medally waranted, a surgeon can place a band in a patient with a BMI of less than 35. There are many who were less than 35 on here who self paid for the reason that insurance would not pay for it due to the low BMI.

Your situation seems to be the opposite.

[MiCollins 0]

Wish me luck. I'm in the North Region. I understand that they use the Metlife ideal weight charts, so by that, I'm 100 pounds overweight. I also have sleep apnea and high blood pressure. Hope this makes me a shoe-in. anyone in the Hampton Roads area have this done?

Michelle

[aNEW_me2011 0]

I am in Texas-the Fort Worth area. Nice to meet you! I am hopeful to finish the pre-op stuff and have surgery around March 10 so that I have all of the spring break to heal.

My doctor mentioned that Tricare changes is mind dailey on whether or not you have to stay the night following surgery. Anyone else hear this?

Im not sure but i know im being treated as an outpaient

[rachelmiller1978 3]

Hi Everyone, I have Tricare prime and just curious about how long of a battle I have here with TriCare if anyone can give me a rough estimate. I am so anxious and impatient and want some kind of guess or comparison how long the process takes. My PCM sent in my referral on May 9th and I received the approval from Tricare on the 16th in the mail, they picked my surgeon so I called and attended the Seminar on June 9th and attended my consultation yesterday(June 29th). I have a 47 BMI and high blood pressure. Just curious what kind of hoops they make you jump through and about how long it takes if anyone can give me their own similar process. Thanks!