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TRICARE! PLEASE HELP

For those of you insured by Tricare, how hard was it to get approved (any details, advice, warnings appreciated)?

Was it easier to get approved under the Tricare Prime Plan or under Tricare Standard Plan?

Did Tricare require you to complete a 6 month diet?

Did Tricare require years of medical records showing a high BMI?

How long did it take to get approved?

Is it true that Tricare South is very flexible?

Edited by Ninamonina

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  • I have Tri Care west and it was easy. Mostly if you're PCM is saying you need it and you are at leat 100lbs overweight they'll approve you! I do not have to do any weight loss prior to surgery either.

  • I have Tricare north Standard, and I was told today, by the surgeon's office, that Tricare requires 6 months worth of documentation of failed attempts to lose weight.

  • 2goldengirl
    2goldengirl

    The reason for different requirements in different areas is because Tricare contracts with different health plans in each area. Each contract is different. Typically Tricare adopts whatever clinical c

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I have Tri Care west and it was easy. Mostly if you're PCM is saying you need it and you are at leat 100lbs overweight they'll approve you! I do not have to do any weight loss prior to surgery either. Soooo it should be the same for you.

Best of luck to you!

I have Tricare north Standard, and I was told today, by the surgeon's office, that Tricare requires 6 months worth of documentation of failed attempts to lose weight.

The reason for different requirements in different areas is because Tricare contracts with different health plans in each area. Each contract is different. Typically Tricare adopts whatever clinical criteria used by that health plan for that area.

  • 2 months later...

I am Tricare south....and they only need 3 month Diet documentation which I am doing at my doctors office.

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