TRICARE WEST HELP!!!!!!!!!!!!

[Newbiexoxo 1]

Hi guys!!!

Any of you here that used tricare prime for gastric surgery???? I am wanting the sleeve. I told my doctor I wanted a referral to see a surgeon. She said she is putting one in for me. I see the status says "pending" can someone tell me their experience? Is this an authorization JUST TO SEE him? and then I meet with the surgeon and THEY send in approval for surgery???? What comes first? Approval for surgery or surgeons requirements?? I am soooo confused because my PCM did not say much. I am seen off base but I am still prime. My clinic was full. Also, how long did it take from the original consult to surgery date for you guys?

[DebReed674 13]

Hi guys!!!

Any of you here that used tricare prime for gastric surgery???? I am wanting the sleeve. I told my doctor I wanted a referral to see a surgeon. She said she is putting one in for me. I see the status says "pending" can someone tell me their experience? Is this an authorization JUST TO SEE him? and then I meet with the surgeon and THEY send in approval for surgery???? What comes first? Approval for surgery or surgeons requirements?? I am soooo confused because my PCM did not say much. I am seen off base but I am still prime. My clinic was full. Also, how long did it take from the original consult to surgery date for you guys?

I have tricare...awesome coverage. I had the band about 6 yrs ago which tricare paid for. I am currently having bypass on April 2nd due to my body being stupid. Now they have to take it out and do the bypass. You will see a bariatric dr who will the see you for a period of time. You'll have to do a list of things before you have the surgery. Psychological evaluation being the top of the list. Depending on your current health, you'll need to see a Pulmonologist, cardiologist, have a specific set of xrays done. Depending on your weight you may be required to shed some weight before surgery. During all this you be required to attend dietary classes once or twice a month depending on your doctor. I have the same insurance as you do. I go to Columbia MO for all my needs. Very good place and great doctors. Hope I helped you. I've attached a photo of before and after my lapband. I have since gained about 60 lbs back due to my problems with the band. Good luck I hope the year or so long process doesn't deter you from being the best HEALTHY you.

Sent from my SM-G970U using BariatricPal mobile app

[Catherine Wible 51]

I have tricare...awesome coverage. I had the band about 6 yrs ago which tricare paid for. I am currently having bypass on April 2nd due to my body being stupid. Now they have to take it out and do the bypass. You will see a bariatric dr who will the see you for a period of time. You'll have to do a list of things before you have the surgery. Psychological evaluation being the top of the list. Depending on your current health, you'll need to see a Pulmonologist, cardiologist, have a specific set of xrays done. Depending on your weight you may be required to shed some weight before surgery. During all this you be required to attend dietary classes once or twice a month depending on your doctor. I have the same insurance as you do. I go to Columbia MO for all my needs. Very good place and great doctors. Hope I helped you. I've attached a photo of before and after my lapband. I have since gained about 60 lbs back due to my problems with the band. Good luck I hope the year or so long process doesn't deter you from being the best HEALTHY you.

Sent from my SM-G970U using BariatricPal mobile app

Looking good!

Sent from my SM-N950U using BariatricPal mobile app

[Akitajade 3]

I had my sleeve done last August with Tricare West and it was absolutely effortless! I asked my primary (civilian) for a referral, and then I called a few days later and scheduled my consultation with the doctor at the local hospital, who was amazing. His office had the referral in their system already, and they took it from there. The six months of required weight loss classes, the nutritionist appointment, the psychological consult (done on the same day in his office) were all included and cost me nothing. A month before the surgery, I had my pre-op bloodwork and paperwork done at the hospital and EKG done, no charge. I was referred for an echocardiogram which cost me a $30 copay. The day of the surgery I paid a $150 copay at the hospital as I was staying overnight. That was IT. My doctor took care of ALL the footwork and final approval with Tricare, all I had to do was show up. They were very strict, however on the six months of supervised classes. I had to go on the same exact day each month and could not miss a class or change the day without the risk of Tricare making me start over. Worth. All. Of. It. Please let me know if you have any questions, my surgery was done at Parker Hospital in Aurora, Colorado.

[Kristinqtpie 42]

I have Tricare Prime and they wouldn’t even give me medicine for weight loss. I’m near Fort Leonard Wood. I’ve ended up going self pay out of state due to getting no help.

[SLBrown68 4]

Hi! I have Tricare Prime-East. I did not have many problems with getting approval for surgery. There is a list of things you have to do to qualify for surgery. My clinic was awesome, everything was very organized and things went very smooth. I am just 2 weeks post-op, but so far so good. I hope you can get answers to your questions soon.

Stavana

[Georgetown 253]

On 3/29/2019 at 3:52 PM, Newbiexoxo said:

Hi guys!!!

Any of you here that used tricare prime for gastric surgery???? I am wanting the sleeve. I told my doctor I wanted a referral to see a surgeon. She said she is putting one in for me. I see the status says "pending" can someone tell me their experience? Is this an authorization JUST TO SEE him? and then I meet with the surgeon and THEY send in approval for surgery???? What comes first? Approval for surgery or surgeons requirements?? I am soooo confused because my PCM did not say much. I am seen off base but I am still prime. My clinic was full. Also, how long did it take from the original consult to surgery date for you guys?

Hi there. I have Tricare Standard so I didn't need a referral to the surgeon. There are requirements in order to qualify for the surgery and every doctor is different what they require, however, Tricare does require, I think 4-6 nutrition visits. I saw the nutritionist on base in CT which was nice to not have to pay for those visits. By the time my surgery came, I had met the deductible and caps so didn't pay anything for the surgery! I feel so fortunate to have Tricare! Best of luck to you!