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Tricare Insurance

lauratro

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sarcruze    24

sarcruze
Posted

I have Tricare Standard and I saw my pcm in July and told him I wanted to have weight loss surgery. My PCM's office took a week and a half to send in my referral. Tricare approved it the day it was sent. Tricare has been super fast with approving referrals and authorizations. Love it!. I saw my surgeon on August 5th and my first weigh-in was on August 11th. My Surgeon's bariatric program is 4-6 months long. I have almost completed my bariatric programs required appts except for the sleep study doctor. I had my sleep study test on Sept 1st but my appt to get my results isn't until Oct 27th. My ecg came back abnormal so now I have to get a cardiac clearance done. I have one more weigh-in and nutritionist appt to do on Nov 2nd. Once I get my cpap fitted and we figure out the appropriate pressure as well as my cardiac clearance done all I need to do is see my surgeon again and we will set a date. I am hoping for December. My bariatrican said that December is usually booked up because everyone is trying to get hip and knee replacements before their insurance renews hahaha. I am still crossing my fingers tho.

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lauratro    67

lauratro
Posted

Does anyone have tricare standard? Right now things seem to be going ok but I go off base for everything and have to find doctors through their provider directory.

Sounds like I'm in the same boat as you. I have Standard so I have to go off post.

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Smdnght28    69

Smdnght28
Posted

I'm on VA beach. Yes I do

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Smdnght28    69

Smdnght28
Posted

Does anyone have tricare standard? Right now things seem to be going ok but I go off base for everything and have to find doctors through their provider directory.

Sounds like I'm in the same boat as you. I have Standard so I have to go off post.

Sent from my SM-N920T using the BariatricPal App

Yes I do. I'm in VA beach

Sent from my iPhone using Tapatalk

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lauratro    67

lauratro
Posted

I have Tricare Standard and I saw my pcm in July and told him I wanted to have weight loss surgery. My PCM's office took a week and a half to send in my referral. Tricare approved it the day it was sent. Tricare has been super fast with approving referrals and authorizations. Love it!. I saw my surgeon on August 5th and my first weigh-in was on August 11th. My Surgeon's bariatric program is 4-6 months long. I have almost completed my bariatric programs required appts except for the sleep study doctor. I had my sleep study test on Sept 1st but my appt to get my results isn't until Oct 27th. My ecg came back abnormal so now I have to get a cardiac clearance done. I have one more weigh-in and nutritionist appt to do on Nov 2nd. Once I get my cpap fitted and we figure out the appropriate pressure as well as my cardiac clearance done all I need to do is see my surgeon again and we will set a date. I am hoping for December. My bariatrican said that December is usually booked up because everyone is trying to get hip and knee replacements before their insurance renews hahaha. I am still crossing my fingers tho.

That's awesome thanks for sharing your story. I hope everything gets approved for you and you get a surgery date. Where are you located?

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imightknow    39

imightknow
Posted

Does anyone have tricare standard? Right now things seem to be going ok but I go off base for everything and have to find doctors through their provider directory.

Sounds like I'm in the same boat as you. I have Standard so I have to go off post.

Sent from my SM-N920T using the BariatricPal App

Yes I do. I'm in VA beach

Sent from my iPhone using Tapatalk

I am at Eustis. I am just starting the bariatric program at Portsmouth. Before I received my referral, I considered going standard and through the bariatric program at Sentara. I went to the orientation last week and see the surgeon on the 10th.

There is a Facebook group, I believe it is called Weight loss surgery with tricare. All of the women in that group are so helpful! They explained the entire process to me beforehand, so that I'd have a greater understanding of tricare and the bariatric programs. There are locals in there too. One just had the surgery in July and she is standard. She is very helpful and helps me with all of my questions. She went through sentara.

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lauratro    67

lauratro
Posted

Does anyone have tricare standard? Right now things seem to be going ok but I go off base for everything and have to find doctors through their provider directory.

Sounds like I'm in the same boat as you. I have Standard so I have to go off post.

Sent from my SM-N920T using the BariatricPal App

Yes I do. I'm in VA beach

Sent from my iPhone using Tapatalk

I am at Eustis. I am just starting the bariatric program at Portsmouth. Before I received my referral, I considered going standard and through the bariatric program at Sentara. I went to the orientation last week and see the surgeon on the 10th.

There is a Facebook group, I believe it is called Weight loss surgery with tricare. All of the women in that group are so helpful! They explained the entire process to me beforehand, so that I'd have a greater understanding of tricare and the bariatric programs. There are locals in there too. One just had the surgery in July and she is standard. She is very helpful and helps me with all of my questions. She went through sentara.

Sent from my iPad using the BariatricPal App

I'll have to look up that page. Thanks for sharing!

Sent from my SM-N920T using the BariatricPal App

I'm in the area too. Going through Madigan. I'm just starting the process now. November I'm going to a gastric surgery seminar appointment. We should create a local group or Facebook page.

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Yes, we definitely should start a page!

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Armygalbonnie    643

Armygalbonnie
Posted

I'm Tricare Prime and had to go off post too. Fort Sill stopped surgeries on Sept 30th. It's been a smooth process. I've spent less than $200 out-of-pocket. My surgeon required 3 visits with a NUT, psych eval, physical therapy eval and 1 support group visit. I started most of the visits on August 1st. I have surgery next Tuesday.

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lauratro    67

lauratro
Posted

I'm Tricare Prime and had to go off post too. Fort Sill stopped surgeries on Sept 30th. It's been a smooth process. I've spent less than $200 out-of-pocket. My surgeon required 3 visits with a NUT, psych eval, physical therapy eval and 1 support group visit. I started most of the visits on August 1st. I have surgery next Tuesday.

That is so exciting! I hope your surgery goes smooth! Thanks for sharing

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Smdnght28    69

Smdnght28
Posted

Does anyone have tricare standard? Right now things seem to be going ok but I go off base for everything and have to find doctors through their provider directory.

Sounds like I'm in the same boat as you. I have Standard so I have to go off post.

Sent from my SM-N920T using the BariatricPal App

Yes I do. I'm in VA beach

Sent from my iPhone using Tapatalk

I am at Eustis. I am just starting the bariatric program at Portsmouth. Before I received my referral, I considered going standard and through the bariatric program at Sentara. I went to the orientation last week and see the surgeon on the 10th.

There is a Facebook group, I believe it is called Weight loss surgery with tricare. All of the women in that group are so helpful! They explained the entire process to me beforehand, so that I'd have a greater understanding of tricare and the bariatric programs. There are locals in there too. One just had the surgery in July and she is standard. She is very helpful and helps me with all of my questions. She went through sentara.

Sent from my iPad using the BariatricPal App

I'll have to look up that page. Thanks for sharing!

Sent from my SM-N920T using the BariatricPal App

I'm in the area too. Going through Madigan. I'm just starting the process now. November I'm going to a gastric surgery seminar appointment. We should create a local group or Facebook page.

Sent from my iPhone using the BariatricPal App

Yes, we definitely should start a page!

Sent from my SM-N920T using the BariatricPal App

Thanks!

Sent from my iPhone using Tapatalk

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FaithInMe    7

FaithInMe
Posted

I'm Tricare Prime and had to go off post too. Fort Sill stopped surgeries on Sept 30th. It's been a smooth process. I've spent less than $200 out-of-pocket. My surgeon required 3 visits with a NUT, psych eval, physical therapy eval and 1 support group visit. I started most of the visits on August 1st. I have surgery next Tuesday.

I'm Tricare Prime also and have completed all vists/pre-op tests (didn't have to see a physical therapist) and will have surgery on Nov 14 - can't wait! Good luck with your surgery and recovery.

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
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