Hello, I'm in the beginning process of trying to get approval from Tricare prime overseas in Germany. I am currently awaiting Tricare to respond to my question but wanted to see if anyone else who has gone through the process or is going through the process has an answer. I wanted to know how many months of documented visits with your PCM showing no weight loss was needed prior to approval. and if once your PCM send the referral in and Tricare approves referral does that mean your approved for the surgery? Thanks to all that respond!!!!

I'm on my last month of the 3 month Dr. Supervision diet, and my surgery has not been approved with Tricare Prime until I'm done with all the 3 month requirements/testing. However, they did approved all the pre appointments just not the actual surgery yet.

are you in Germany? so did your dr. tell you about the 3 months needed or was it Tricare that told you?

I'm not in Germany... I am in the US and I Have Tricare Prime South. My bariatric navigator gave me a form which had all the Tricare requirements which was 3 months for me. I know it varies with Tricare on how long you have to do the Dr. Supervised visits. I have a friend that had to do 6 months. I also have another friend that didn't have to do any.... so it's either a hit or miss depending on where you're at.

thanks for the help!!!

No problem! Best of luck to you on your journey!

I'm with Autumn2013. I also have Tricare Prime and am in my first month of supervised food journaling.

Now my only question to you is are you having the surgery at an Army Hospital (I'm pretty sure or you wouldn't be using Tricare) if that's the case the patient advocate should have a road map of what to and he/she is the expert on what insurance companies require.

If the answer is no and you're planning on having it done at the German Krankenhaus then I might be inclined to say they may not cover it.

I hope this helps.

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I have no been told the location I would have the surgery, weather it would be in landsul or on the ecomony. I will check into all this, thanks!

I have no been told the location I would have the surgery' date=' weather it would be in landsul or on the ecomony. I will check into all this, thanks![/quote']

Good luck! Boy you are bringing back memories. Landstuhl. Wow! Spent 3 years in Central Germany. No offense to the Deutsch but I would need my surgery done in an American Hospital.

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Hi CAnthony,

I am in Germany also. Have you had any success yet. Still working on tricare.

I have I'm having my surgery on feb 18. You have to have 6 months of weight loss appts with your PCM with weigh ins and see nutritionist monthly as well....once it is shown that you can only loss 10 lbs or so then you can start process through your PCM. You have to do a referral for every step...every appt! Good luck!! If you need anything let me know....hey where are you??

I switched to tricare standard and all I had to do was find a surgeon. I was approved in about 2 weeks and only had to do one nutrition visit and the psych eval. They don't do the lap band at Darnall so thankfully I don't have to have surgery at an army hospital.

I have tricare prime and in the south region and did not have to have doctor supervised diet. From first appt to surgery was right at 3 months! I wonder why each region is different?

Hi Canthony...I am in Hohenfels. I just do not understand why Tricare is different everywhere? I asked them before and they said is should be the same everywhere...Go figure? AnywayI am finding it hard to get anywhere with my doctor. He said they are hardly ever approved. I am 5'2 and 220 lbs so I am definitely over BMI. My problem is the paper work the doc fills out still goes by weight and not BMI which is the new policy. I have tried explaining it over and over but he says he has to go by what the authorization says. Any advice? TIA!!

april

Hi All,

I thought about switching to Tricare Standard but the Tricare rep told me it would not matter I would still need the approval from my PCM? Any advice??

With Tricare Standard you don't need a referral. I just made an appointment with the surgeon. Once I was at my appointment they explained they would need tricare approval and you either had to to have a BMI of 40 or greater or have co morbid conditions. It took 2 weeks and I was approved for the surgery as well as the nutrition visit and the psych consult. Once I had completed that my surgery was scheduled. My advice would be to switch doctors. Do some research find what doctor has approved it for other people, and then make sure you tell them you have been fighting your weight for at least 10 years and have tried every diet out there plus weight loss drugs. I didn't have to do supervised weight loss or attend any seminars. Also if they say no appeal it if you need to. Don't take no for answer. Hope this helps