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

Wow- just informed Tricare not covering sleeve


Guest

Recommended Posts

Guest

I'm in my 5th month of the supervised diet - all preop stuff done- just waiting for time to pass and was informed today (by chance!!) that Triwest will not cover the sleeve. I am in shock. I called Tricare and they confirmed this, but said maybe a different code would work? The CPT code given by my doctors office is 43775.

Has this happened to anyone else? I live in Alaska so going down to the lower 48 would be a challenge. And costly.

Share this post


Link to post
Share on other sites

Go to Mexico I did almost two weeks ago. Dr. Guillermo Alvarez. It was fine no troubles.

Share this post


Link to post
Share on other sites
Guest

It's cost prohibitive for me at this time :(

But I'd love to hear about your experience! How are you doing with everything?

Share this post


Link to post
Share on other sites

I was told this also. I was not given another code to try because I hadn't started the process yet. I just figured I'd have to have the gastric bypass done instead. Anyone know why Tricare isn't covering it now?

Share this post


Link to post
Share on other sites
Guest

Well my drs office says it will be a few months before they cover the sleeve. They think Bc Medicare covers it now, tricare will follow suit, but they are much slower about it. Next month I will be finished w my 6 month supervised diet, so they are going to submit for the sleeve anyway. I'm not counting on an approval.

Share this post


Link to post
Share on other sites

I have Tricare Reserve Select and was told today that they won't cover the sleeve. The insurance lady at Dr office said it may be 12 - 18 months before Tricare will approve the sleeve for coverage. Tricare will cover lapband or bypass with an out of pocket expense of $150. My 1st appointment is April 29th for consult, psych eval and nutritionist. I was hoping it may be approved during my 6 month diet but I've found out I only need to do 3 months.

I've read that people are getting it done at Military hospitals and clinics. I called a clinic 90 minutes away and they do it. I need to have my civilian doctor send a bariatric surgery referral and go from there.

I don't understand why Tricare won't approve it, but you can have it done at a military hospital.

Share this post


Link to post
Share on other sites

I have tricare prime and I am having the sleeve surgery on the 24th. I was told it is corded because I am having it at a military hospital. If I were to go to a hospital off post, only the bypass would be covered.

Share this post


Link to post
Share on other sites
Guest

Hi- thanks for all the responses. As luck should have it, my local MTF is starting to do bariatric surgeries next month. I have already met w the surgeon. :0). He will be doing the sleeve hopefully next month. I am finished w all my preop stuff so it's just a waiting game at the moment.

It won't seem real until I get a date though. :0)

Share this post


Link to post
Share on other sites
Guest

Oh and curious, to those that had it done at an MTF, did your center require a 6 month supervised diet? Ours is (luckily I have already completed it), but new patients will have to have the 6 months first.

Share this post


Link to post
Share on other sites

Mine did not. The only diet I have to do is a two week pre op liquid one. I started it yesterday.

Share this post


Link to post
Share on other sites

I realize this is an old post, but are there any new updates to triwest or uhc covering the sleeve? If so, do they still require the 6 month diet and any pointers to make sure I put myself in the best possible position to get approved?

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

I realize this is an old post, but are there any new updates to triwest or uhc covering the sleeve? If so, do they still require the 6 month diet and any pointers to make sure I put myself in the best possible position to get approved?

Sent from my iPhone using the BariatricPal App

I am curious too if there have been any updates. I have Tricare Reserve Select North Region and I know they cover they sleeve, I'm just curious if they require a 3 month or 6 month supervised diet or non at all. The website doesn't state any. I go next Wednesday for my first consultation with the surgeon and nutritionist. Hoping I will find out something then.

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

    • 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.
      · 0 replies
      1. This update has no replies.
    • 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

        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

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

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 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

    ×