Hi, all!

So, I'm a newly-married military wife, and I know that TriCare covers weight loss surgeries. I've read from a few topics on here (http://www.bariatricpal.com/topic/175096-tricare-now-covers-vsg/ for one, but there were some others) that mention that they cover gastric sleeve. I've already read the TriCare site, where it mentions the prerec of BMI/co-morbidities, but I want to know more about the process. I'm just curious what kind of experiences you've had with the whole shebang - what sort of tests and appointments did y'all have to go through before the surgery, was TriCare easy to work with, how much it cost, etc.
I'm new to this whole dealing with insurance thing, and since there's a lot of back and forth on the whole whether or not the sleeve is covered bit, I just thought I'd ask and see what the community reaction was.

Also, any info on gastric sleeve surgeries in/near the southern Illinois area would be extra cool. Thanks in advance!

Edited November 24, 201411 yr by wifeaf

I am in Boise ID. I was originally going to have the sleeve done at the MFT in Germany. After a lot of red tape and drama they sent us to Mt. Home instead of Lakenheath. I took everything as a sign that I was not meant to have the surgery. I even got a referral here to the bariatric clinic but decided to wait. I really wanted to have the sleeve done. This is awesome news.

My experience going to the MTF is there are no set rules. It is up to the surgeon and his program. The surgeon at Landstuhl did not make me do a 6 month diet and didn't really do a ton of tests. He did do the EDG since I do suffer from heart burn. I was one week away from surgery and he pulled my date since Lakenheath would not take me if I had he surgery.

Looking back on the entire experience I realize that it was not really helping me prepare for the true outcome of the surgery. There were no support groups or help for after the surgery. The surgeon hadn't really done that many surgeries and I would have had to stay in the hospital for a week and basically be on my own after surgery. I am a firm believer everything happens for reason and I was meant to come to Boise and wait just 6 months for the surgery I want to be available by a group of doctors that work with bariatric patients daily. There are great support groups and very good follow up. I am so happy I didn't have the surgery in Germany. I don't know what the future hold for me as far as the surgery but I am thrilled about this news.

One thing I learned it this....if any of you guys want to go over seas after your surgery they make you wait 5 years post-op and no issues in that 5 years. We are at the end of my husbands career so we are willing to take the risk.

I am in tricare south (humana military). I have my seminar scheduled for 12th of Jan. For me my PCM referred me. BMI 35 and 1 co-morbidity. I was approved with no problem.

I was also told sleeve isn't covered through tricare. However, Our hospital on base does the sleeve and the hospital is covering cost and doesn't go through tricare at all. General surgeon called and scheduled seminar. I stopped in and spoke with nutritionist and she explained that process in more depth. All is required is 2 support groups (1 can be attended pre-op) which is what I did. 1 psych eval. She gave me number for that and said I can have that done prior to seminar as well. Did that last week. When I called and scheduled appt. She submitted to Tricare for approval that day and they covered it 100% next day. I meet with nutritionist same day as seminar. Then labs will need to be done again and meet with surgeon. Thats it. She said since seminar is Jan. then procedure will be Feb or March since December patients are being scheduled for Jan. No out of pocket expense and no tricare authorization. They said once general surgeon office called I was automatically approved! My PCM did not think I would get approved because I'm low BMI for their standards but I got a call few days later. I also spoke with people in support group (pre-op and post-op patients) they all verified that is the process. No 6 mth pre-op diet. Just the liquid diet right before surgery to shrink liver!

I know that if you have it done at a MTF it is free, but I don't have one near to me. So I would go to a hospital in my area and use a civilian surgeon as well.

The tricare site still says it's not covered. I'm going to keep going with my process anyway, I know after 20yrs of being associated with the military, active duty and now a dependent I know updated info trickles in like icebergs. LOL

Yep. I agree. Everything is so slow. I'm at Travis AFB and they would do it but I would never go to the MTF for anything. I see civilians for everything.

Good luck with your process!

I totally agree with never going to a MTF again. I am seen by all civilians and I have had the best care ever! Since we live 50 miles from base they allow us to still be in Prime.

Yes since my family and I have had many surgeries and hospitalizations via civilians and mtf's we have had good and bad experiences at both. Just have to do your homework and research no matter what doctor, program and facility you choose. All drs. Have to do their first surgery and build to become experienced. Even experienced drs. Make mistakes as well. So just make sure that you choose a surgeon that you feel comfortable with and if it doesn't feel right then keep looking until you do!

Hi all! I'm with Tricare North and I'm also getting the sleeve. I was told it is now an approved procedure and we are going through the process of what I need to get done to have it! Make sure you call directly since not everyone may be informed and website information may not be updated correctly. Good luck everyone!~Dawn~

Did you guys have to do a six month wait to see a nutritionist? Just wondering what the requirements are since I will not be seen at a MTF this time?

Hi Lindsey. I saw my nutritionist day 1 of my first visit. I see her each time I go. I ha to to for 6 months of visits tho. I'm going thru Allegheny Health Network facility in Pittsburgh Pa and I do have Tricare North. You will need an endoscope, ekg, treadmill test for your heart, sleep study, all your gyne updated and full bloodwork done. Welcome to the site and good luck to you. I'm 3 months in. Half way. My apt is on Jan 7th for my next one. Il looking at April/May for my surgery. Good luck! If you have any questions you can always contact me!

Awesome! I figured I would have to do 6 months. Since I was originally going to have it done at a MTF they wanted to get my records from there to see if I don't have to do all six months again. We will see what happens. I had the EDG done last year but I think they will want to redo it. Six months out will be good for me since the two guys I work with wife's will be having babies in the next three months. I am in Boise ID

Well that will work out well for you then! Good luck to you!!!

~Dawn~

Did you guys have to do a six month wait to see a nutritionist? Just wondering what the requirements are since I will not be seen at a MTF this time?

Hi Lindsey - I didn't have to do the 6 months; I had documentation from a 5 month liquid diet from Jan 2013 and that met the requirement. Tricare only requires a "documented attempt at weight loss" prior to the surgery. No duration and no timeline. Good luck and I hope it works out for you!

Did you guys have to do a six month wait to see a nutritionist? Just wondering what the requirements are since I will not be seen at a MTF this time?

Hi Lindsey - I didn't have to do the 6 months; I had documentation from a 5 month liquid diet from Jan 2013 and that met the requirement. Tricare only requires a "documented attempt at weight loss" prior to the surgery. No duration and no timeline. Good luck and I hope it works out for you!

This is great news! Maybe I won't have to wait to long for surfer then????

I spoke with my surgeon's PA and she told me the sleeve is covered by Tricare for their office as of November. She did tell me I have to do 6mths of nutritional counseling. So I won't get my surgery until August at the earliest. I will need that time to get all the other stuff needed as well. AND I need to work on ME and get myself in the right mind frame for this journey.

What all criteria is neededHopefulMe3016? I have Tricare North and I'm also getting the sleeve. I was told by my office I didn't need to complete a food journal but I needed all the testing. Do you know what all is needed? Do you have to wait the full 6 months?

Anyone have any additional updates on Tricare?