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Why Must This Be So Hard With Tricare?

Ok so my husband and I are stationed in Ohio. He is Army and a recruiter, so we don't have an MTF, but there is one an hour away, Wright Patterson AFB. I called them and asked if they perform the VSG and they said they don't do that surgery on base anymore! Seriously? This is the one time in my life I have been so sure about this decision and now I am basically being told I can't have it done. I don't want gastric bypass, I know a few friends that have had it done and have had many complications and I'm a bit scared of all of that. The LapBand was my second choice, but I don't want to settle just because Tricare and the hospital is being difficult. Now I'm stuck and I don't know what to do....any suggestions?

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No I do not they are going to discuss it with me at my next appointment July 13th. Hoping for the best preparing for the worst. The worst being two week liquid diet. I think I over heard 5 days liquid so that is what I am hoping for.

  • 1 month later...

Hello,

I'm new to this site, but I am a Navy Vet who just got out in June and I have started the process of getting the sleeve. I'm currently going to the Ship-Shape class (its on week six now) at NAS JAX. My friend that I met at 2010's class told me to go ahead and do as much as I can before I have my appt at General Surgery. My appt with GS is on Friday and I'm a little confused as to what happens next. I have read what Smellbug has posted, which was very helpful, but is there anything that I could possibly do to speed a surgery up before December?

The biggest issue that I have is that I have only been extended tricare-prime until 12-20-2012 and after that I'm on a reserves tricare which is totally different.

Hello' date='

I'm new to this site, but I am a Navy Vet who just got out in June and I have started the process of getting the sleeve. I'm currently going to the Ship-Shape class (its on week six now) at NAS JAX. My friend that I met at 2010's class told me to go ahead and do as much as I can before I have my appt at General Surgery. My appt with GS is on Friday and I'm a little confused as to what happens next. I have read what Smellbug has posted, which was very helpful, but is there anything that I could possibly do to speed a surgery up before December?

The biggest issue that I have is that I have only been extended tricare-prime until 12-20-2012 and after that I'm on a reserves tricare which is totally different.[/quote']

The thing that will slow you down is the Mandatory 5 support group meetings. The support group meetings are once a month and you need 5 of them before you have surgery. Have you gone to any? If not there is one this Thursday. We are meeting at Sweet Tomatoes on Wells Rd. at 530. It's good that you started ship shape. When you go to general surgery they will have you make appointments for your psych evaluation, EDG scope your stomach, and check if you had a physical, lab work and pap done with in the last year. Let me know if you have any other questions. Hope I helped.

Tara

I would also say make all your support group meetings and explain to them/your coordinator that you would like the surgery before the Tri-care prime expires. I hope you find someone who will work with you.

Thanks!

Does the group coordinator report how many meetings you have been too? How does that work? Is it possible to jump around to different groups Mayport/Jax until I have 5 group meetings? Where is the Psych (at mental health)?

Thanks!

Monika :D

I am actually out at Mayport. The only support group is at NAS JAX. We have to sign in and put the last 4 of your sponsers social. The psych is referred out I went to one over here in the regency area.

Tara

Also they let me schedule surgery this month. I have everything done but the support groups. My last support group meeting is Sept. 13th my surgery date is Sept. 18th. They let me schedule now and told me if I miss any they will cancel my surgery and push me back until I have 5 meeting.

Tara

Thanks Tara!

I'm going to show up Thursday at the meeting, Who should I look for? Do you all wait outside first? I really appreciate all the help I'm getting this late!

This is our first time not meeting at general surgery. Nurse Massari is the coordinator and she will be there. They did not say exactly where to meet. I would say look for a group of about 20 people. There will be pre-op and post-op people there. See you there.

Tara

Hi Tara!

Do you know the dates and times for the support groups? Is it every 3rd Thursday of each month?

Thank you in advance!

Monika

They normally post the meeting schedule a few months in advance. I only know up to Sept. since that is my last one. The Sept. meeting is Sept. 13th at 430pm at general surgery. When u go to general surgery on Friday ask about the meeting schedule. Good luck

Tara

Thank you!

Tricare isn't there to help and they can make everything more difficult than it needs to be.

But the real issue is that Tricare doesn't cover VSG. At all. Ever. We all keep hoping that they will eventually but they don't yet. Your PCM can refer you off post but Tricare will deny you. It's not covered and they're not flexing on it yet. Hopefully next year.

However, it's possible to have the surgery done at a MTF if they perform the operation. MTFs make their own rules on those "extra" surgeries they'll cover for training purposes or special programs. You just have to jump their hoops and get through the wait list.

So to the poster worried about Tricare Prime expiring, it's a non-issue if you've got a local MTF that does the surgery.

To the OP, your best bet is to see if you can have it done anywhere else in your commute area. But Ohio is scarce on bases. Maybe Knox? It's not too far, maybe five hours from WPAFB.

I've seen people jump bases to have it done, but most of them seem to live within an hour or so of the other base or they have a different base that does the surgery near their home of record. You can always try, though.

I lived in Germany and no MTFs were doing the operation. I took out an unsecured loan through USAA and after lots of research chose to go with Dr. Aceves in Mexico. I did research Dr. Curry in Cincinnati, though, so if you go the self-pay route, he's a nearby option and had a very helpful staff.

Perhaps the next assignment will put you closer, or if your home of record is by a MTF that does it, you can always call and see if you can get it done on leave, though that could be a challenge if you don't have family to stay with for recovery and for visits you'd have to make prior to surgery.

Good luck with whatever you decide. In my case, it simply wasn't worth the trouble and I didn't want to wait. I don't regret my choice to self-pay one bit.

~Cheri

clk,

Thank you for the information! I never thought about trying to get it done at another military hospital. I will look around.....

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