Has anyone been approved?

Well I won my appeal! It's not even going to cover half but I am glad it is covering some. It pays to stick with something!

Yay Mary!!! I am so glad you won. Wish it was more but it helps.

Congratulations! That's great news!!!

Susan

Thank you ladies.....scheduled for late April!

Hi Mary-

Any advice on the appeal process with Tri-Care? How did you finally win?

I wrote a letter stating briefly my journey and explaining the continued success of my weightloss would depend on the skin removal. I believe it helped that I submitted a letter from my bariatric surgeon as well as my PCM that is was necessary and not for cosmosis.

I haven't been officially rejected yet, I am assuming. My doctor put the authorization in on Friday. I had the ryn-y 21 months ago and have maintained my 135lb weight loss for the past 6 months. I have the sores, rashes and infections. It's all very well documented by my PCM and now a surgeon. I have heard it's near impossible to get approved right out the gate so I am trying to learn as much as I can from other Tri-Care patience who have had success. We are active Prime but would consider changing to Standard if it would help my cause.

You have one shot to appeal the denial. The letter you write is important so take your time with it the only other thing is to pick a plastic surgeon that will fight for you? Mine was imperative in getting the appeal reversed.

Tricare paided for my tummy tuck. I had my band and in 2011 I had my tummy tuck in 2013 and was covered. Im' now having a revision from band to bypass on the 30th that tricare is covering also

I received my approval for both the panniculectomy and abdominoplasty. I was feeling very confident they would approve the panniculectomy portion but figured I would have to pay out of pocket for the rest. I am feeling very blessed for the dual approval, I know in today's TriCare would it's highly unusual. Surgery set for 21 May.

I received my approval for both the panniculectomy and abdominoplasty. I was feeling very confident they would approve the panniculectomy portion but figured I would have to pay out of pocket for the rest. I am feeling very blessed for the dual approval, I know in today's TriCare would it's highly unusual. Surgery set for 21 May.

How did you get them to approve it? I'm having so many skin problems it's not even funny.

I received my approval for both the panniculectomy and abdominoplasty. I was feeling very confident they would approve the panniculectomy portion but figured I would have to pay out of pocket for the rest. I am feeling very blessed for the dual approval, I know in today's TriCare would it's highly unusual. Surgery set for 21 May.

Congratulations!! As I said, Tricare is only covering the panniculectomy. My plastic surgeon didn't even submit for abdomnioplasty as it is strictly cosmetic and won't be covered which I believe because he had to talk with tricare multiple times just to get panniculectomy approval. I am content with the discount I am getting and now focusing on the procedure and recovery......you should hear from me next week!

Anyone have AETNA insurance? Ifso how long did your approval for plastics take? on breast reduction or TT...

Post op day 3 of abdomnioplasty and couldn't be more happy!

Mary. Do you have pics? I fought my denial and won for panni. Surg june11th. Do you have idea what $ amount they paid?