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Tricare Approval

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Dave_NW    92

Dave_NW
Posted

did anyone with tricare have to do six months of dieting?

Tricare does not have a six month diet requirement. Go to the Triwest website and search the database for the exact wording of what they will and won't pay for.

Having said that, your surgeon may have a requirement. You'd need to ask them about it if it concerns you.

Dave

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LaToya    0

LaToya
Posted

Thanks Dave. I spoke with Coordinator and she says it is a Tricare rule. Tricare says it isn't. I am not getting a good feeling about this place. I will talk to the doctor on the 28th and see what he says. Tricare even told me to find a new doctor if they don't at least submit it. Could just be the coordinator didn't know what she was talking about.

Thanks again!

Tricare does not have a six month diet requirement. Go to the Triwest website and search the database for the exact wording of what they will and won't pay for.

Having said that, your surgeon may have a requirement. You'd need to ask them about it if it concerns you.

Dave

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Dave_NW    92

Dave_NW
Posted

Thanks Dave. I spoke with Coordinator and she says it is a Tricare rule. Tricare says it isn't. I am not getting a good feeling about this place. I will talk to the doctor on the 28th and see what he says. Tricare even told me to find a new doctor if they don't at least submit it. Could just be the coordinator didn't know what she was talking about.

Thanks again!

Insurance Coordinators are supposed to be on top of the regulations. If this person isn't up to date, you definitely should bring it to the attention of someone who can change that. My experience with Tricare was that they are very specific about what they require, and what they will approve. In my case, it ws three days between date of submission, and when I was approved for surgery. No six month diet required.

If other thngs aren't stacking up, don't hesitate to move to a different clinic. You need to have confidence in your surgeon's team.

Good luck!

Dave

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crafty mama    0

crafty mama
Posted

how do you figure out the 200% rule?

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YngGram    73

YngGram
Posted

how do you figure out the 200% rule?

My guess is

Small framed--being able to get your hand around your wrist (I think)

100 lbs. is your ideal weight and you weigh 300

I had the comorbs so I fell into the 100 lbs. over group..

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • LeighaTR

      LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.

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