Tricare Question

[lagray13 5]

Hi, my name is Leigh Anne and I’m in the beginning stages of researching bariatric surgery. My husband is retired military so we have Tricare prime. I’ve seen the requirements for surgery and I do qualify according to those, however, I’m unsure how to prove my failed weight loss attempts? Maybe I’m overthinking. Also, the nearest base is about 45 minutes from here, would I be required to have my surgery on base or could I use a network surgeon (if I can find one)? I appreciate any input and advice you may have for me.

[:::fluffy::: 9]

Look for network doctor preferably associated with a hospital. They have great programs

Sent from my SM-G950U using BariatricPal mobile app

[jesseycakes 103]

For me, I didn't really have to prove that I tried and failed. I had done Weight Watchers in the past, but no way to show that I did. I've tried to do it on my own, no way to prove that. All I had to do when filling out the paperwork was to write down that I had tried them, when I tried them, and did I lose weight and keep it off. I didn't go through the military insurance, but I am assuming it will be along the same lines. Good luck!

[ahunter88 8]

I'm retired and getting the sleeve next week. I use tricare. They simply asked me what kind of programs I've participated in and what I've done in the past to lose weight. They did not ask for proof. They do have nutrition classes you have to attend and little tests you have to complete and pass. Along with a support group you will have to attend at least once.

[ahunter88 8]

Now this is in San Antonio, Brook Army medical center. I started my journey 28th of August, 2018. Most people have to wait 6 months or so to get through everything and to surgery. I got lucky with my timing and completed the nutritional courses in 1 month and attended the support group that same month. I had most if my lab work done by my doctor (who had a sleeve done last year) who knew what I needed. Bamc is ranked in the top 5 bariatric programs in the United states. One reason I looked into this.

[ahunter88 8]

Oh I forgot. Tricare will not cover an outside the base provider because it is an "elective" surgery.

[Frustr8 7,886]

Like We All Choose Obesity? Just some more Fat Bashing in My Book! Bariatrics is Not a Trivial "Fun" Surgery, we often turn THERE because All Else Fails.

[AFVet 26]

I’m retired too. I used to be Tricare Prime but I got kicked off a few years ago because I live over 100 miles from the nearest MTF (San Antonio). I’m TRICARE STANDARD. I’ve actually had the surgery approved twice since 2012. I backed out the 1st time wanted to try on my own again and the 2nd time I opted for the LAPBAND over the BYPASS because bypass was way too radical a procedure for me and the SLEEVE was not yet approved by TRICARE. My surgeon talked me out of the lapband and said I should wait for Tricare to add the sleeve as an approved procedure. Which they finally did 2 years later. Had my sleeve in mid-August and have now lost 68#. You don’t have to prove a thing to Tricare about you diet progress or attempts...Your Doctor and surgeon will write up a letter for the Tricare review board that will get you approved, I’m sure of it. You’ll be joining us a a sleeved member real soon. Good luck

[Bob R 6]

Hi, my name is Leigh Anne and I’m in the beginning stages of researching bariatric surgery. My husband is retired military so we have Tricare prime. I’ve seen the requirements for surgery and I do qualify according to those, however, I’m unsure how to prove my failed weight loss attempts? Maybe I’m overthinking. Also, the nearest base is about 45 minutes from here, would I be required to have my surgery on base or could I use a network surgeon (if I can find one)? I appreciate any input and advice you may have for me.

If you go through tricare then you will be following tricare rules which are more restrictive than going through a military hospital I am also 45 minutes away ( Walter Reed) but I would suggest going through a military Dr and he or she will tell you your options. Good luck.........Bob

Sent from my SM-G900T using BariatricPal mobile app

[lagray13 5]

Thank you all for your advice and experience! I visited with my PCP yesterday and she sent the referral off to the bariatric surgeon and it was approved by Tricare today! I did the online seminar for the surgeon today and I'm currently waiting for them to contact me back after they review insurance information! I'm really hoping everything comes through!

[AFVet 26]

That’s great, you’re on your way and it won’t be long now. Even if something snags up, your PCP will help push it through. Start rounding up the Protein Shakes for the pre-op liver reduction diet. Trust me it’s going to seem like it’s coming at you fast from now on! Good luck!

Edited November 28, 2018 by AFVet