Hey all,

I'm in the process of trying to get approval for surgery from tricare, already have the referral from my pcm...I just wanted to how everyones journey to getting approval went...And whether or not you had your surgery at an MTF or of post...Well hoping for a few responses thanks!!!!

Hi all

I am a retired dependent and had my lap-band surgery 11/2006 at Ft Belvoir VA. Dr. Ryan and Dr. Carmondy did my band. They have both left the military now and I go to Walter Reed for my fills. Since I did not have to go civilian I had no trouble with Tricare…..but now I am looking to the tummy tuck which was suppose to be part of the whole package. Seems Tricare is very slow on approving this. Has any one checked in to this yet or had any issues with it?

Thanks

Deb

I have Tricare Prime and started the process in Feb and just had mu surgery done off post July 8.

I'm just starting the process too. I went to my PCM last Fri and he put in the referral and it was online today (Mon), approved for an office visit with a local surgeon. Woo hoo! I'm just waiting for the coordinator to call me back with the time for an orientation and then to schedule the consultation.

I am also TRI PRIME. I am a dependent, when I found out that Tri paid for LAPBAND I started the process got my referral, went to seminar in April, went to phyctrist, talked to nutristnist, and talked to the surgeon, did my blood work and stress test, now I am waiting for the corodinator to call and schudule my surgery, then I will have to do a 5day diet of liquids. Also my surgeon requires every patient to pay $380. for something I forgot for what but it is in my paper work. I am happy to know that they pay for tummy tucks.:tongue_smilie:. PLEASE EXCUSE MY SPELLING:blushing:

I am a dependent of a retiree and I have TRI PRIME, I was diagnosed w/breast cancer in 2007. My chemo was close to $80,000 and TRI PRIME paid all I only pd $12.00 co-pay, on my radiation I pd close to $500. The surgeon that is doing my Band requirs all of his patients to pay $380. for something I forgot what. I am just getting really excited waiting on my surgery date.

Carolyn, did you say that Tricare will pay for a tummy tuck? How did you hear that? Is there a reference in the policy manual. It would be great news, but I didn't think they did!

Carolyn, did you say that Tricare will pay for a tummy tuck? How did you hear that? Is there a reference in the policy manual. It would be great news, but I didn't think they did!

Unless it has changed in the last month since I was in the Tricare office, they don't usually. There has to be a medical necessity and a long battle.

Tricare doesn't advertise it but I have talked to several people who have had band and RNY get tummy tucks through Tricare. They consider it as a two part plan. BUT I believe there has to be some issue with the skin---rashes and such. Instead of calling Tricare, go to your local Tricare Service center and ask someone there.

BUT I believe there has to be some issue with the skin---rashes and such.

Hence why I said medical necessity. My friend had her bypass 10 years ago and his been fighting for a tummy tuck for the last five years. She just finally had it approved and done 3 weeks ago. Tricare fights paying for anything they believe is a cosmetic procedure.

I know two gastric bypass patients here who've had Tricare Prime pay for tummy tucks, and one of them got a breast lift paid for too. Both of them had the procedures done less than two years after their bypass surgery. I have another friend who is having surgery this month, she's getting a breast lift and Tricare is paying for that too, and she's never even had WLS.....makes me wonder what they're telling their doctors!

Edited July 16, 200818 yr by gina s.

That's strange. about the fill thing...it is just costing them more in the long run!

As far as the breast reduction/lift. I was approved for one a couple of years ago, but wanted to lose weight first. I have documented upper back issues. As far as the TT, if this is something you are wanting, take pictures of any skin conditions that you have because of the loose skin..any yeast infections, any redness, etc. Any time you have problems, go to the Doctor so that it is documented. Then, when you are ready, you can submit all of that.

Unless it has changed in the last month since I was in the Tricare office, they don't usually. There has to be a medical necessity and a long battle.

Unless I misunderstood but I read it somewhere on here and just got real excited:lol:. I will check further and let you know.

Unless it has changed in the last month since I was in the Tricare office, they don't usually. There has to be a medical necessity and a long battle.

Unless I misunderstood but I read it on here somewhere but I will check on it further and let you know, I think it should be covered but that is just me:thumbup:

Hey all my military friends come vist at the military spouse unite sub forum under the social chat. Great fun!!