I have been looking into the lap band and decided that because our insurance is such a pain that I would go self pay in Mexico but after researching I think I may try and get approved thru our insurance anyway and if that doesn't work then I'll go self pay. Anyone with Tricare Prime insurance have an easy time getting an approval?

wow! thats awesomw! i also have a suvillian doctor. so far its gone by fast. did you have to do the 6 months of seeing the dietician? I dont know yet if im going to have to do that. what was your bmi? good luck!

It was pretty awesome. I had to see a nutritionist twice pre-op, then she came by my room before I was discharged post op. I had to have my psych consult and that was the extent of my pre op requirements. Everything has been covered by Tricare except for the nutritional consult which cost me $50 because I didn't want to wait 3 months to see the on base dietician/nutritionist. I chose to pay the $50 fee to get it done and over with.

My initial consult was July 22nd. I had my Nutritional and Psych consults on July 29th, and I was approved the following Monday.

My BMI was 49.4 pre op, and today 22-23lbs lost my BMI is 45.2

Tricare has been phenomenal through this entire process. I also want to state that I had zero co-morbidities and was approved strictly on my weight. Tricare did not consider my BMI, or anything else. I did not have diabetes, thyroid, or any other of the standard co-morbidities that Tricare normally requires. I was 140lbs overweight, and that was enough for Tricare Prime approval.

If you need further information on lap band surgery insurance and all please do browse my signature link as well...

Hi, I had the this procedure done and i am insured under tricare prime. My procedure was on february 20th of this year. As far as tricare prime goes it has the minimal requirements, and it will completely cover all expenses. You need a couple thing inorder to get ur referral from the insurance for the consultation. You need to have your primary doctor recommend you for the surgery, you need to be 100lbs over your structures normal weight and you need to have hypertension, diabetes, or a couple of other medical problems that come along with being morbidly obesite. Once you have those down it's pretty much very easy from there. It's a bit of a prolonged process, but if you're serious about having the surgery done, it's completely worth it.

I don't recommend Mexico procedure because they're not as educated nor experienced as our surgions in America. Not only that, but the people who get their procedure done in Mexico or out of country end up having serious complications.

I'd just deal with Tricare. They're a pain in the butt most times, but with this surgery, honestly i had no problems with the insurance.

Hope this helped...:wink:

My Pcm on base referred me to a surgeon with no problem. The only thing Tricare required from me was a Psych Eval. I got that done and was approved within 2 days. My surgery is March 16th. I am with Tricare West aka Triwest. My insurance does require me to stay overnight since I am in the state of Arizona. I wish you the best of luck with your journey Hun!! God Bless!!

I have tricare prime and just had my surgery on the 13th. I will say it was a nightmare for me to get approved but don't give up.I appealed it twice al the way to the sec of defense and got approved.Don't let them give you the run around. Tricare says yOu have to be one hundred pds over weight according to the met life tables and one co-morbidity or 200% over your ideal weight !! its not as much as you think!! I was 5'4 and 235 so i met both requirements. if you need more info please feel free to contact me Good luck

GINNIE

Edited March 1, 200917 yr by azairforcewife
8 PDS LOST