Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Tricare Approval



Recommended Posts

I had my consult today and found out there is a one time fee not covered by ins. it is $1000!!!!!!!!!!!!!!!! And the doc charged $200 for the Protein Shake mix. Is this normal or is this crazy? I have tricare prime and thought it was all covered. I dont know what do now.

Share this post


Link to post
Share on other sites

Hi, it is should be fully covered if your surgeon is a tricare participating provider. Mine was, so I did not have to pay anything, only for nutrition eval. I would double check this doctor with Tricare. If he is a participating provider; then he can only charge Tricare the contractual agreement amount. That is it. Call tricare and ask about your cost share.

Share this post


Link to post
Share on other sites

Congrats!!!!!!!!!!!!!!!!!! I'm scheduled for next Friday, YAHOO!!!!!!!!!!!!!!! I am Tricare Approved, too.

Share this post


Link to post
Share on other sites

I went in and had my psych eval today and she gave me the go ahead. Now I am just waiting for the stupid doctor to write my letter and send my records over...why must they take so long?? ugh! it's been 2 weeks! it's terrible! but once the surgeon gets all that they'll be submitting to Tricare and hopefully I'll have my surgery by this time next month!! Keeping my fingers crossed!

Share this post


Link to post
Share on other sites

If the doc is a tricare provider (which this one is) can they get in trouble for charging more money?? The receptionist said the 1000 I needed to pay was for aministrative costs.

Share this post


Link to post
Share on other sites

I would call tricare and tell them they are charging an administrative fee, and I would ask them if this is acceptable? I do not think they will be to pleased to hear that if he is a participating provider.

Share this post


Link to post
Share on other sites

Congrats!!! Let me pass on some info. My provider asked for $600 upfront, to pay for fills afterward. So I called Tricare and gave them the code they were filling the money under. It was an old code that was no longer used. So claims from Tricare said that if the dr. office will write out, what the money is used for, the reciept can be submitted for some reimbursement. "Wordage" is what it's all about. Good luck.. D'

Share this post


Link to post
Share on other sites

I have finished all of my required medical tests, psych evaluation and have not had to pay anything. The only thing I have left is a diet and nutrition class on May 15 that will be $60 and that I do have to pay. I had my EGD today and as soon as Tricare sends the approval I get to schedule my surgery!!! :biggrin:

Share this post


Link to post
Share on other sites

I had to pay a $300 fee to my surgeon's office and that covered the psych consult and nutritionist fees. I was glad to pay it, though. $1000 sounds pretty steep to me, however medical providers can pretty much charge whatever they want in terms of fees. I would want to know the breakdown of those charges...and find out from Tricare if those are charges that would normally be covered.

Share this post


Link to post
Share on other sites

I just found this site today and am very interested in these TRICARE posts. I signed up for Prime and will see a PMC for the first time in May at Keesler AFB Biloxi. Is anyone aware of a Lap Band surgeon in the Biloxi that accepts Tricare? Appreciate any info you can share. Tks

Share this post


Link to post
Share on other sites

I just found this site today and am very interested in these TRICARE posts. I signed up for Prime and will see a PMC for the first time in May at Keesler AFB Biloxi. Is anyone aware of a Lap Band surgeon in the Biloxi that accepts Tricare? Appreciate any info you can share. Tks

I went to the Tricare office on my base and they gave me a list of surgeons within a four hour driving radius that took Tricare.

Share this post


Link to post
Share on other sites

I too just got apprived my Tri West.. Took only two days.

This forum has been so hlepful . I didn't know till reading this how to check on my referral.. So I am almost a member now of the Bandits and have my pre-op appt. Wednesday...

Please tell me you would do this again ...

Anxious in Arizona

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×