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TRICARE

Hello,

I have Tricare Prime, and i have already gone through my PCM and got the referral (which was a breeze by the way), I am scheduled for my Orientation on Feb 10. I was wondering has anyone already completed the tricare prime orientation and if so what did it consist of?

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  • sapphire12305
    sapphire12305

    I haVE TRICARE PRIME too. The referral is for the consultation, they have to submit it to get approved for surgery, that is the tricky part. I had to have physc evaul, which they did at my doctor

  • Hi Shandra! I'm Tricare Prime (south Texas) After the referral for the bariatric consult was obtained, I needed: 1. Initial evaluation by the bariatric surgeon 2. three meetings with the s

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Hello,

I have Tricare Prime, and i have already gone through my PCM and got the referral (which was a breeze by the way), I am scheduled for my Orientation on Feb 10. I was wondering has anyone already completed the tricare prime orientation and if so what did it consist of?

I have Tricare Prime, and didn't have to do any orientation, or any of the other things I read about, like the psych evaluation, the diet, etc. But I hear Tricare South is different than the other regions.

Wish I could help, though!

  • Author

I haVE TRICARE PRIME too. The referral is for the consultation, they have to submit it to get approved for surgery, that is the tricky part. I had to have physc evaul, which they did at my doctor office for lap band, i had out of pocket, could of went thru tricare but would of drug it out longer.. They dont do that surgery at the base i'm at, i'm in AZ. I got the referral and thought wow approved, later is when i learn that is only for consult. good luck and you'll love the band!!

Hello,

I have Tricare Prime, and i have already gone through my PCM and got the referral (which was a breeze by the way), I am scheduled for my Orientation on Feb 10. I was wondering has anyone already completed the tricare prime orientation and if so what did it consist of?

Hi Shandra!

I'm Tricare Prime (south Texas) After the referral for the bariatric consult was obtained, I needed:

1. Initial evaluation by the bariatric surgeon

2. three meetings with the surgeon's nutritionist.

3. psychologist's evaluation (is your motivation justified, are you likely to comply)

4. Attend one hospital based support group meeting.

5. Demonstrate ability to start conforming to controlled diet, ie... LOSE 5% OF CURRENT BODY WEIGHT AT TIME OF REFERRAL (in my case, about 15 pounds)

6. I believe the BMI requirement is pre-determined by Tricare, but a lower BMI is considered, IF you have co-morbidities (high blood pressure, cholesterol, arthritis, diabetes, etc)

Hope this is helpful... and good luck :)

Hello & Welcome!

I have Tricare South and was just banded. I went backwards through everything yet it only took me 3 months from the time I started everything. When I went to get my referral they wouldn't give it for the doctor I wanted whom had the most experience and I trusted. I walked into the base Tricare office and they helped me. That day I switched to Tricare Standard for Active Duty and didn't even need a referral or to do anything else but qualify. The ladies said this was the best way for me to do it. I'm SOOO happy I did!! Good Luck!!!

I have Tricare Prime. My PCM sent the referral in and about 3 days later I went to the "free" seminar at the surgeons office. Did the psyc eval that was paid for, then I did have to pay for nutrition and exercise but thats the only thing I had to pay for. Once I did the things my surgeon required to have the lapband done, they submitted an approval for the surgery. Tricare called me and told me that I was approved and my surgeons office was sent a letter. After about a week or maybe less, I went to a pre-op appointment and the surgery was scheduled from there. I had no problems and it was fast. Total time was about 5 weeks for me. Now that I am 3 1/2 months post-op I have to get some more approvals for more fills but its not a problem. Everything is completely covered for 90 days after surgery, then approvals will need to be done prior to your fills. If your Dr has done tricare before its fast and simple. Good luck.

I have Tricare Prime, and went through things as they came up. My PCM was happy to refer me - all I had to do was ask. The surgeon I chose was one of very few in Washington State who do lap band AND take Tricare Prime insurance, so it made the choice fairly easy. (Swedish Hospital in Seattle.) I attended their required seminar, then scheduled the office consult. On that day I met with a psych, a physician, a nutritionist, and the surgeon. It was a marathon day, back-to-back appointments that took half a day. Easy thing to do, as it handled everything on the same day. I had an Endoscopy two weeks later to confirm I also had a hiatal hernia, after which the surgeon sent the request for surgery approval to Tricare. Three working days later I had my approval. I had my surgery at a convenient time after that, which was about eight weeks ago. Things are going fine, I feel great, and my only regret is that I didn't do this years ago.

Good luck!

Dave

biggrin.gifThanks everyone for the information... im just getting so antsy with waiting for this orientation and not knowing what happens at it. So at the time of each of your referrals what were your stats(if you dont mind me asking)?

-Weight

-Height

-BMI

-Any Co-morbilities

the orientation consit of the doctor talking about the 3 tyler os Weight loss surgerys. Band, sleeve and bypass. It's alot of info that you may already know if oyu have done research already. Recovery time. What to expect from the surgery. I requested my referral in sept and was banded in middle nov. I love it but do your own research and know what you want. :) good luck

I have Triwest (prime). Here was what I went through:

Saw PCM and got referral to surgeon

Attended free seminar where they talked about the surgeries. Dropped off referral letter at that time

Had pysch eval. I had to pay for that out of pocket approx $250

Attended a nutrition class

Then I had to see my PCM to get the tests ordered for blood, chest xray, ekg. I got the EKG right in the office, the chest Xray 20 minutes later and blood work next morning because it had to be fasting (something to think about if you want to do all your tests in the same day) **If it takes forever to get an appointment with your PCM, you may want to make that appt now even though the surgeons office will tell you to wait. You can always cancel the appointment, but it took me 3 weeks to get in and they wouldn't order the tests over the phone, but the PCM did give me my clearance letter and everything right at that appt. If I had made my appt sooner, I may have got to have my surgery a month earlier. Picked up my lab and chest xray results about 5 days later.

Had consultation with surgeon. They would not schedule my consult until I had the results of my blood tests, etc. That is when they scheduled my pre-op class and my surgery.

Attended pre-op class. Bought some supplies so I wouldn't have to do it later.

Had surgery 9 days later (due to holidays).

Start to finish was Nov 1st and surgery was Jan 7th.

Good luck!

  • 2 weeks later...

Hello,

I have Tricare Prime, and i have already gone through my PCM and got the referral (which was a breeze by the way), I am scheduled for my Orientation on Feb 10. I was wondering has anyone already completed the tricare prime orientation and if so what did it consist of?

My dr has the Orientation online, so took the 45 minutes to watch it before my Appt, I got an appt the next day and he submitted my paperwork.

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