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Tricare Prime

How long does it take to.be approved for lap band with tricare prime if ur bmi is 41 and have high bp and a diabetic? Do they require u to do a 6 month diet?

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  • Unfortunately tri west requires 6 months of weigh ins with your Pcp. From what I'm understanding on these forums triwest is the only tricare that requires this. Ive tried calling several times and eve

  • I have heard that Tricare is cutting this procedure being covered. trying hard to get approved.

  • Went to gyn md today they agreed to be my supervisor to diet plan. Please cross your fingers

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I was approved in less than a week

I was wondering the same thing! I have Triwest and I meet BMI. I also have a fatty liver and documented joint pain. I hope my process goes fast. I've never been more than ready. I have my first consultation this week :) Hope everything goes smooth for you!

Unfortunately tri west requires 6 months of weigh ins with your Pcp. From what I'm understanding on these forums triwest is the only tricare that requires this. Ive tried calling several times and even asked my surgeons office if they knew any way around this and they said no triwest was pretty strict. I was so bummed when I found this out because I was ready to get it done asap and I thought my 6+months of weight watchers would work. On the bright side I'm three months into it and most of my other preop stuff is done. I'm just taking this time to get myself prepared but I'm very anxious to get it done. If you do hear a way around the 6 month wait please share. I have tricare prime remote. Good luck!!

I am on Tri West also, I wonder what's going to happen when the new insurance company takes over in April!

I'm nervous about the change in insurance too. I'm hoping to be done with my preop stuff and aproved before they change but I'm going to be cutting it really close.

I am hoping that I will not have anymore fills because I think there will be a lot of cutbacks!

I have Tricare prime...Triwest is my region, 6 months of medically supervised diet and exercise is required in my region but I believe other areas may differ.. I completed my 6 months plus all the testing, I have a surgery date and now I'm awaiting approval after having to get a pcm referral problem fixed..should know any day now! I personally think Triwest is a nightmare to deal with..spoke with 7 different people there today and got 7 different answers! I wish you Good luck!

  • 3 weeks later...

I agree same thing happened to me

Is there a difference between Tricare Prime and TriWest? I was on Tricare Prime before and got approved without any supervised dieting - Will I have to when my husband goes active duty again?

Triwest is just the region of the States that I live in...there is Trinorth, Trisouth and overseas too...Tricare Prime is the actual insurance! :)

I live in Louisiana. I am struggling with Tricare. I actually have 3 insurances but since insurance 1 and 2 doesn't cover bariatrics I am forced to use Tricare. 5 times I called Tricare to receive 5 different answers. one rep told me I would have to drop insurance 1 and 2. I dropped one and that made me nervous. I called finally and got a supervisor who told me not to drop my other insurance. my bmi is 39.5 I have no co morbidities, however every one in my family has diabetes including my dad who died at 45 of the disease. I just knew sleep apnea would be my ace in the hole, I had a sleep study, much to my surprise I have no apnea!! my only hope now is to do the physician monitored diet. I have been on weight watchers since 2011 but wasn't concurrent with physician monitoring. I have an apt with my GYN doctor on Wednesday, I feel certain he will help me out. my question is do I need to keep my weight stable or show loss or gain. I really really want this procedure!!!! the lady at Tricare said "well it sounds like you will get diabetes so if you do call us and we will probably pay for the procedure" Really??? that's what I am trying to avoid. any advise is greatly appreciated.

newbie, I was told by a Tricare rep that with a bmi of 40 or greater its an automatic approval.

I have heard that Tricare is cutting this procedure being covered. trying hard to get approved.

I live in Louisiana. I am struggling with Tricare. I actually have 3 insurances but since insurance 1 and 2 doesn't cover bariatrics I am forced to use Tricare. 5 times I called Tricare to receive 5 different answers. one rep told me I would have to drop insurance 1 and 2. I dropped one and that made me nervous. I called finally and got a supervisor who told me not to drop my other insurance. my bmi is 39.5 I have no co morbidities, however every one in my family has diabetes including my dad who died at 45 of the disease. I just knew sleep apnea would be my ace in the hole, I had a sleep study, much to my surprise I have no apnea!! my only hope now is to do the physician monitored diet. I have been on weight watchers since 2011 but wasn't concurrent with physician monitoring. I have an apt with my GYN doctor on Wednesday, I feel certain he will help me out. my question is do I need to keep my weight stable or show loss or gain. I really really want this procedure!!!! the lady at Tricare said "well it sounds like you will get diabetes so if you do call us and we will probably pay for the procedure" Really??? that's what I am trying to avoid. any advise is greatly appreciated.

I stayed the same weight throughout my 6 month supervised diet, so losing is not necessary..it's the documentation that is necessary...have you visited a weightloss surgery center?....they are the ones that told me what I needed to do in the beginning and they were the ones that requested Tricare for my surgery...I wish I could help you more..

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