Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Tricare prime



Recommended Posts

I've been on the phone all day trying to figure out the actual requirements set by triwest... According to my surgeons office tricare requires a 6 month diet plan that is supervised by your pcm, but then when i called the triwest hotline they say that there is no time limit set forth.. I really feel like all the customer service people aren't educated at all on any of the insurance coverage, because all they are reading to me over the phone is what I can access on the tricare webpage under coverages. I'm just getting super frustrated!

Share this post


Link to post
Share on other sites

I've been on the phone all day trying to figure out the actual requirements set by triwest... According to my surgeons office tricare requires a 6 month diet plan that is supervised by your pcm' date=' but then when i called the triwest hotline they say that there is no time limit set forth.. I really feel like all the customer service people aren't educated at all on any of the insurance coverage, because all they are reading to me over the phone is what I can access on the tricare webpage under coverages. I'm just getting super frustrated![/quote']

Share this post


Link to post
Share on other sites

I've been on the phone all day trying to figure out the actual requirements set by triwest... According to my surgeons office tricare requires a 6 month diet plan that is supervised by your pcm' date=' but then when i called the triwest hotline they say that there is no time limit set forth.. I really feel like all the customer service people aren't educated at all on any of the insurance coverage, because all they are reading to me over the phone is what I can access on the tricare webpage under coverages. I'm just getting super frustrated![/quote']

Yes I got the same info and even though TriCare told me there was no time set forth my Dr office tried to submit and it was rejected. At first I was really angry but not looking back I really did need the six months to fully grasp the idea! It is a serious life change. Don't be discouraged. Also if you are able you can go to a Military Treatment Facility and have any procedure, sleeve included without a six month wait.

Share this post


Link to post
Share on other sites

Excited for you....good luck tomorrow...and keep us posted when you can! Lisa

Thanks Lisa!!! I am excited and nervous however I have no time to focus on it because I had to take this Colonoscopy Cleanse drink that has had me in the Bathroom since 3:00 this afternoon!!! My Doctor is serious about making sure that the stomach and bowels and colon are EMPTY!!!! I have to arrive at hospital at 11 and no eating after midnight!!! I think that I am being tortured into losing weight this is bananas!!! :P

Share this post


Link to post
Share on other sites

Thanks Lisa!!! I am excited and nervous however I have no time to focus on it because I had to take this Colonoscopy Cleanse drink that has had me in the Bathroom since 3:00 this afternoon!!! My Doctor is serious about making sure that the stomach and bowels and colon are EMPTY!!!! I have to arrive at hospital at 11 and no eating after midnight!!! I think that I am being tortured into losing weight this is bananas!!! <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/tongue.png' class='bbc_emoticon' alt=':P' />

Actually be glad your doing that... I know sounds weird but I've had colon cancer and had colorectal surgery. A couple of years later I needed a complete hysterectomy due to a genetic reason (I should be as famous as Angelina Jolie, lol) my doc made me do the cleanse which totally pissed me off but I swear my recovery was SO MUCH easier than this surgery and I swear it was because I was so bloated from all the gas and then constipated from two weeks of Protein shakes with little to no fiber! Hope all goes well today for you! It will be so worth it in the end!

Share this post


Link to post
Share on other sites

Actually be glad your doing that... I know sounds weird but I've had colon cancer and had colorectal surgery. A couple of years later I needed a complete hysterectomy due to a genetic reason (I should be as famous as Angelina Jolie, lol) my doc made me do the cleanse which totally pissed me off but I swear my recovery was SO MUCH easier than this surgery and I swear it was because I was so bloated from all the gas and then constipated from two weeks of Protein Shakes with little to no fiber! Hope all goes well today for you! It will be so worth it in the end!

I'm ALL DONE GUYS!!!! This is how my day went...... I arrived and checked in at 11:00 immediately got started and was originally scheduled to stay overnight HOWEVER...... I went into surgery at 11:45 in Recovery by 1:30 and released by 4:30!!!!! I am sitting here typing feeling like a million bucks I came through surgery with flying colors and they found no need to monitor me overnight...... I am so blessed!!! Lets see what The morning brings.... and I say bring it On!!!

Share this post


Link to post
Share on other sites

YAY.......it is reassuring to hear such a positive result. So excited for you!!!

Share this post


Link to post
Share on other sites

GOOD NEWS! Tricare approved my surgery.....on my pre-op diet.....surgery is a go for 8 July! Hope my experience is as easy as RoyalRags....! Lisa

Share this post


Link to post
Share on other sites

I've been on the phone all day trying to figure out the actual requirements set by triwest... According to my surgeons office tricare requires a 6 month diet plan that is supervised by your pcm, but then when i called the triwest hotline they say that there is no time limit set forth.. I really feel like all the customer service people aren't educated at all on any of the insurance coverage, because all they are reading to me over the phone is what I can access on the tricare webpage under coverages. I'm just getting super frustrated!

I did not have the 6 month diet. Perhaps you can tell your PCM that the requirements have changed and that you contacted Tricare directly. Maybe he/she will go ahead and refer you! Best of luck...Lisa

Share this post


Link to post
Share on other sites

GOOD NEWS! Tricare approved my surgery.....on my pre-op diet.....surgery is a go for 8 July! Hope my experience is as easy as RoyalRags....! Lisa

Yaaaaay Lisa that's great!!!!! Congrats! It should be a piece of cake!!! I'm still feeling fabulous! When they give you the pain meds or any meds you need to crush them up to take them! Otherwise you feel them also your throat will be a little sore from the breathing tube sugar free iPopsicles are perfect for that I'm taking tums and Pepcid although I have no symptoms but it keeps them away so it doesn't hurt!!!

I have been going all day and now I'm resting with a heating pad to ease swelling and gas!!!

Share this post


Link to post
Share on other sites

GOOD NEWS! Tricare approved my surgery.....on my pre-op diet.....surgery is a go for 8 July! Hope my experience is as easy as RoyalRags....! Lisa

He'll yes!!!

Share this post


Link to post
Share on other sites

I'm ALL DONE GUYS!!!! This is how my day went...... I arrived and checked in at 11:00 immediately got started and was originally scheduled to stay overnight HOWEVER...... I went into surgery at 11:45 in Recovery by 1:30 and released by 4:30!!!!! I am sitting here typing feeling like a million bucks I came through surgery with flying colors and they found no need to monitor me overnight...... I am so blessed!!! Lets see what The morning brings.... and I say bring it On!!!

Omg! Good for you! I'm so happy for you!

Share this post


Link to post
Share on other sites

I've been on the phone all day trying to figure out the actual requirements set by triwest... According to my surgeons office tricare requires a 6 month diet plan that is supervised by your pcm, but then when i called the triwest hotline they say that there is no time limit set forth.. I really feel like all the customer service people aren't educated at all on any of the insurance coverage, because all they are reading to me over the phone is what I can access on the tricare webpage under coverages. I'm just getting super frustrated!

I just went through the process with triwest - united healthcare military west. It was 4 weeks from consult to surgery. Message me if you need any help.

Share this post


Link to post
Share on other sites

Omg! Good for you! I'm so happy for you!

I couldn't be happier!! I posted a Pic on my profile check it out!!! XOXO

Share this post


Link to post
Share on other sites

Need help figuring this out, ive been lurking on this site since I decided I wanted lap band surgery and I love how supportive you all are. I've been trying to get my lap band approved through Tricare prime since January. I finally made it through all the hoops with my civilian doctor and fulfilled all their requirements and got Tricare to approved me, but since I am in an area with a military treatment facility, Tricare said they had to give them first right of refusal. The MTF decided they would do the surgery. I am really frustrated because when I called there, the bariatric nurse wasn't there but the person that I talked to said I might have to redo several of the steps using the MTFs requirements. For instance, they said they require a 6 month diet vs. the 3 month diet my civilian doctor required. They said I also might be required to attend their seminar and see their psychiatrist, along with a few other things.

Does this make sense to you? I am so frustrated!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×