Tricare South no Health issues??

[Kimberly Johnson 1]

I just joined this group today and I just scheduled my first appointment today with Tricare, I meet the BMI requirement however, I do not have any known health issues. Is the surgery still a possibility for me? I want to be able to avoid health issues from being over weight, is this taken into consideration? Also is there a standard waiting period from time started to surgery date?

I know there are multiple questions in this post, but thanks to all that answer.

[Sosewsue61 3,185]

You have to look at what your policy states, go online and download the secifics as each insurance is very different.

[Kimberly Johnson 1]

I did and below are the requirements. I do not have doctor documented proof of weight loss, I do have print outs of my fitbit tracker that shows my weight in the last year and my orders from weight loss companies. I do not know if this is enough, as I do not have any health issues that I am aware of.

From below I current meet - age 18 or older and proof of a 44 to 46 BMI. Its just my medicals records, I do not think shows my diet plans over the last 2 years.

All of the following conditions must be met to qualify:

• You're at least 18 years old or you must provide documentation of completion of bone growth.
• You were unsuccessful with non-surgical medical treatments for obesity. Your medical records must show your failed attempts.
  • Diet programs, such as Weight Watchers^®* and Jenny Craig*, are acceptable methods of dietary management, as long as there are monthly clinical visits with your doctor and medical documentation of your participation and your progress throughout the course of the dietary program. *These programs are not covered by TRICARE.
  • Physician-supervised programs made-up of only weight-loss medication management, do not meet this requirement.
• You have proof of one of the following:
  • A body-mass index greater than or equal to 40 kilograms per meter squared (kg/m2); or
  • A body-mass index of 35-39.9 kg/m2 with one clinically significant comorbidity, including but not limited to, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea, Pickwickian syndrome, hypertension, coronary artery disease, obesity-related cardiomyopathy, or pulmonary hypertension.

[Berry78 4,259]

It is typical to undergo a "supervised diet" for 3 months to a year (6 months is the most common). This "supervised diet" should meet that requirement.

Look for a program near you that accepts Tricare, and they will tell you what the process will be.

[confusedturtle3 246]

I am on Tricare standard but I believe it works the same for standard & prime. I am currently on the 3 month medically supervised diet program, 2 months in. I am just over a 40 BMI and my comorbidities are not on the list but the doc says they count for Tricare. Mine are GERD, osteoarthritis in my back and a hiatal hernia. I will be having my final doc appointment in October and hopefully scheduling my surgery soon after. Your doc will go over all of the comorbidities etc with you, but you will likely need to have the 3 months supervised diet, psych eval, you will need to attend a support group meeting and a lot of med testing as well. You will have to have 1 comorbidity if you are BMI of 35-39.9 and if you are 40.0 and up there are no required comorbidities.

[Kimberly Johnson 1]

I have created a group on FB specifically for Tricare, if y'all want to join. Just to support and figure out the process together. I literally just created it as I did not really find much, at least when I searched.

https://www.facebook.com/groups/359086584533097/

[Kimberly Johnson 1]

I am beyond nervous, tomorrow is my first appointment. Fingers crossed it goes well 🤞

Sent from my SM-N920V using BariatricPal mobile app

[Losing2Win4me 1]

I have created a group on FB specifically for Tricare, if y'all want to join. Just to support and figure out the process together. I literally just created it as I did not really find much, at least when I searched.
https://www.facebook.com/groups/359086584533097/

Is your page private or closed?