Tricare now approves lapband

[dallman 0]

I am still tring to find out. It says I am approved so the nurse thinks all I need is a psyc eval but that is for my doctor not Tricare. I have that appointment set up for Thursday and will try to get more info then if I don't get it before then. She is supposed to call me later on today. I will let you know when I have more information.

Don

[minpinmom 2]

minpinmom

I read on one of your posts that you are in Conroe, I am in Magnolia. Tried to email you, but my work comupter blocks EVERYTHING. Where are you in your journey? I see my surgeon for the first time today, fingers crossed for ins. approval.

Hi Abeaher,

We are very close - we should keep in touch so we can have a local support - I have read that there are Lapband support meetings in The Woodlands, but I haven't gone to any yet. I have seen the surgeon, had a psych eval, and they are submitting to Tricare (I just hope it comes through) Feel free to email me anytime (well, I guess not from work :-) wendy@beldwinkennels.com

[mommakatx2 0]

I have in my possesion a letter of approval for my banding from the tricare appeal board. After over two years of waiting I am on my way. Thanks to everyone for any help that you have given me. :rofl:

Don

THAT is FRIGGIN AWESOME!!!!! YEAH!!! :whoo: Congrats to you and thanks for sharing with us!!!! Here's hoping the rest of us can now follow suit.

[Jesusislove 26]

This is wonderful news dallman, they are finally doing their job. Let us know the what they required of you. Congrats and thanks for all your information and input on this site.

[minpinmom 2]

Hey guys - I got a call from Brandi (a supervisor at Tricare South) - they received an email today that the Lapband is covered, their computer software won't be updated until 1/25, but the email with the approval was sent system wide today, if you talk to them and they say it is not in the system, tell them to check their internal email, they received an email TODAY that states it is covered - the only thing is - the OPEN procedure is still NOT covered, it has to be done laproscopic.

Can I get a hoo rah!

[mgordon1 0]

Hi Everbody - guess what I have, my approval/tracking number from Tricare. :-). They even approved my out of network doctor because the surgeons in my area (Northern Cali) most physicians know that Tricare did not cover the lapband and therefore the doctors did not take the insurance. I made sure that the service center was well aware of that. All I have to do know is get a surgery date from my doctors ( hopefully Feb or lates March) and the best part about this - not out of pocket expense other than my co-pay at my doctors office. 2008 is looking up.

[Sgt Bob 1]

Hey guys - I got a call from Brandi (a supervisor at Tricare South) - they received an email today that the Lapband is covered, their computer software won't be updated until 1/25, but the email with the approval was sent system wide today, if you talk to them and they say it is not in the system, tell them to check their internal email, they received an email TODAY that states it is covered - the only thing is - the OPEN procedure is still NOT covered, it has to be done laproscopic.

Can I get a hoo rah!

hoo rah!

There's more where that came from!:whoo:

[dallman 0]

Talked to my nurse this morning Tricare requires nothing else from me. What ever they sent in orginally is all they needed. I know the letter from my Doctor was a over a year old. If you want a laugh they called the nurse this morning to see if I had the surgery yet. I will have mine the end of the month or the first week of Feb. I am required to do the 2 week diet before surgery. Will update you later as I know more. I tested to see if I'm sane enough for the surgery tomorrow and stress tested next Wed. None of which is required for Tricare.

Don

[dallman 0]

I have my surgery date. January 28th. This is so easy after finally getting tricare to approve it. The paper work they sent in on me was compiled in Feb 2006. Nothing else needed. See you on the other side (band).

Don

[mgordon1 0]

:biggrin:I got approved from Tricare for lapband. Will update when I get a date.

Dallman - congratulations on your surgery date.

[Lilpeach_059 0]

I went for my 1st appt...the MD is weary of tricare...I should have printed out the change in the manual. The receptionist swears they (tricare) dont approve lap band, I asked her to call Tricare ASAP b/c it is approved (she wants to wait until she has something in writing)!! Hopefully I'll have a date soon!!

:eek:

[mommakatx2 0]

mgordon, that's fabulous news! I'm thinking I won't be approved becasue I don't have any comormidities. My seminar is tomorrow and I'm excited, but no longer as hopeful.

I talked with a rep from Tricare North today who said it's still NOT a covered benefit. I don't understand...how is that some of you are getting approved yet Tricare still thinks it isn't covered? Freakin' Tricare, is all I gotta say.

Anyway, congratulations to everyone who's been approved, keep those of us still waiting updated on your process!

[mgordon1 0]

My surgery is scheduled for 1/30. My pre-op appt is 1/18. Ok, now I need some help on what to purchase or make sure that I have prior to surgery. Any suggestions would be appreciated

[Sgt Bob 1]

After directing someone at Tricare to the appropriate changes, I finally got them to say LapBand is covered. I talked to someone else who said surgury (in general) does not have to be performed by a "Network" doctor, as long as they accept Tricare Standard. The surgical group I've been talking to checked with their insurance dept, and Tricare told them the surgery could only performed by a "Center of Excellence" (C of E). Problem is, the only center of excellence within Tricare's 100 mile search on their website is not listed as network. However, a couple other surgeons who are listed in the Tricare network (who also perform LB) are not with a C of E.

Typical tricare (as I always called it when I was driving truck) clustertruck.

I spent about 2 hours on the phone today, I reckon I'll be spending a considerable amount of time on the phone again tomorrow.

Has anyone else had trouble getting approved out of network? (silly question I know)

[mgordon1 0]

Sgt Bob - I have Prime, however, the doctor that I chose is not a Prime doctor only standard. Another note, the hospital that I will be with is a Center of Excellence. I don't know if that made a difference. Good Luck