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Tricare will only do a gastric bypass, Tricare will not authorize a sleeve. I called numerous times and they stated it was policy. They did authorize me for a gastric bypass but I couldn't do it. I went and had the sleeve done.

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Tricare will only do a gastric bypass, Tricare will not authorize a sleeve. I called numerous times and they stated it was policy. They did authorize me for a gastric bypass but I couldn't do it. I went and had the sleeve done.

Ya know I had that feeling! My doctors office told me on day 1 it was covered now by them as of just a few months ago but something is just not sitting right with me. I had a feeling it wasn't. I don't want the bypass. Now I'm really bummed ???? So did you pay for your sleeve out of pocket? I may end up just doing just that myself. Thanks for your information

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This is a bummer as we want to get my son the gastric sleeve.

It sure is hillbillienurse :( Ive had a message into my doctors office to do some investigating since last week and once I see what they say again I'll let you all know also. I'm just super upset cause as I said before I asked about this at my very first visit and I stated I didn't think it was a covered item and they said oh no as of 3 weeks ago it is now covered. And that was in November. I'm checking again.

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I am getting the sleeve through Tricare. It is covered. I am going to a civilian doctor. When I called the patient rep said "oh you have Tricare - just so you know the doctor was just at a conference and they announced that they will now cover the sleeve so if you want it we will submit for it." They submitted for it and I got approved in 3 days! It's covered. I feel so bad for everyone stuck on the misinformation that the Tricare line is giving. It's covered! And not just at the MTF! I'm going a civilian Doctor who is in the Tricare network as a network provider.

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I am getting the sleeve through Tricare. It is covered. I am going to a civilian doctor. When I called the patient rep said "oh you have Tricare - just so you know the doctor was just at a conference and they announced that they will now cover the sleeve so if you want it we will submit for it." They submitted for it and I got approved in 3 days! It's covered. I feel so bad for everyone stuck on the misinformation that the Tricare line is giving. It's covered! And not just at the MTF! I'm going a civilian Doctor who is in the Tricare network as a network provider.

No way!!!! Are you totally serious?!? I am so excited right now and such a feeling of relief! So they were right! Oh I want to kiss you! Lol. Do you know what their requirements are for it? What all do you have to do for them to cover it? Wahooooo!!!!????????????????????

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My surgery date is 2/1. All they require is the psych eval, surgeons consult note and dietician's consult note. You won't get cleared by surgeon unless you have met the BMI requirements and have done all the tests (GI, labs, chest X-ray). You won't get cleared by the dietician unless you have proof that you have tried a non-surgical physician supervised attempt at weight loss in the past (I provided documentation of a liquid diet I did through Kaiser - Optifast - in Jan 2013). Once you have all that, the doctors office needs to submit for the sleeve (as well as anything else you are considering). It will be approved. Do I need to take a picture of my auth letter????

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I am getting the sleeve through Tricare. It is covered. I am going to a civilian doctor. When I called the patient rep said "oh you have Tricare - just so you know the doctor was just at a conference and they announced that they will now cover the sleeve so if you want it we will submit for it." They submitted for it and I got approved in 3 days! It's covered. I feel so bad for everyone stuck on the misinformation that the Tricare line is giving. It's covered! And not just at the MTF! I'm going a civilian Doctor who is in the Tricare network as a network provider.

No way!!!! Are you totally serious?!? I am so excited right now and such a feeling of relief! So they were right! Oh I want to kiss you! Lol. Do you know what their requirements are for it? What all do you have to do for them to cover it? Wahooooo!!!!????????????????????

Lol!!!! I am soooooo serious!!! You have to have something showing you tried weight loss before. They say Weight watchers is ok as long as you were going to the doctor and being weighed but if you have regular doctors appointments where you discussed weight and regular weigh ins, they'll take it! Plus all the stuff i said above! :)

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It's so annoying because when I asked why the reps still say it's not covered, they said it's because they have to go off of what's on the Tricare.mil site. Until that site is updated, they will keep saying it's not covered!

Your doctor just has to submit for it. It will come back approved if everything else is fine. If it is denied it will be for something other than "it's not a covered service".

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The doctors office did try to say they weren't sure that my Optifast diet would work because it was only for 5 months and it was over two years ago (Jan 31 to Jun 6 of 2013) but I had sent Tricare an email because I wanted it in writing and they responded that there were no specifics pertaining to the duration or the timeline of the last weight loss attempt. You just have to have tried to lose.

Doctors office submitted it on a Monday in the evening, Tricare reviewed it on that Tuesday and needed the doctor to clarify if it was inpatient or outpatient. They clarified and when I called Wednesday am it was approved.

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I did things on my own with weight watchers over a years time and lost 80 pounds but wasn't being followed by my doctor at the time. Also a few times he prescribed me meds to lose weight but but not a whole lot happened with it. So now what!?!? I have really nothing to show.

Right now I'm getting too close to the cut off with my BMI. It's 36 right now with my last weigh in. I last got weighed in I was 197 but then she had me take off my shoes and I was 196 something and she took it to 195 cause they round it. I'm only 5'1. I can't afford to lose anymore before the sleeve or I won't get it. I'm very bottom heavy. I carry it al below. It was my pcp who referred me. Wonder if that would help ... All these questions I still have

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I'm super excited for you!!! Your time is going to go sooooo fast!!!! That's just a couple weeks from now!!!! Wow! And from what I see in the picture you are so pretty! You've been a wealth of help for me and I truly appreciate it a lot! Where are you from? I'm in Pittsburgh. My husband is in the Airforce so I'll be getting this done at a regular hospital and not at s base hospital. I'm so super excited for you!!!! Please let me know how you do and message me! I'd love to keep in touch with you if you'd also like to!

Dawn

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Get the bypass with tricare. It's worth it.

Thanks for your input Txn26!! So glad you are super happy and feelin good! Us Tricare peeps need to stick together! ????

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    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 1 reply
      1. Phil Penn

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      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
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    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • 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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

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