Tricare approval

[Stay_Tuned 0]

I got the approval today from Triwest! No surgery date yet.....

My story....

While stationed in Italy I started the process however at that time only bypass was approved... I found out that I couldnt have it done at the base we were stationed at because there was no aftercare... DH and I talked about it and when we got to the USA I started Optifast at a weightloss clinic ALL OUT OF POCKET... I had a lot of success. I lost 100 lbs in 6 months.....had gallstones and had to have that removed...I spoke with my surgeon at the time and he said.. please do not do bypass... IF Tricare ever offers Lap Band then look into it....now a year later 60 lbs have crept back on... after doing research AGAIN...I found that Tricare now approves Lap Band YES so off to the base I went.....

I scheduled an appt with my PCM.. he was very supportive and refferred me to a bariatric surgeon. I had to wait 3 weeks to attend the infomational seminar. I did that on Monday the 21st of April. I scheduled my psych. appt for the 30th of April and today Triwest received the paperwork from the surgeons office and I am approved! I am awaiting a call from the Surgeons office to schedule the appt. to see the Doctor. Appt is now scheduled for May 5th to meet with the surgeon

I fall into the weight guidelines for Tricare and it was a quick process..... I hope those who have struggled with their PCM's can find one who believes in this as mine did...

Stay tuned for more of my Journey!!

Edited April 25, 2008 by Stay_Tuned
Appt scheduled

[Long2BFree 12]

Congrats on getting approved. I hope my approval will come that fast. I was very happy when I found out that Tricare decided to cover the procedure and started the process once I found out they were.

[aculberg 0]

Stay tuned ~ what base are you at? I also am under TriWest, stationed at Hill AFB, UT. Went to see my PCM and she was all about the diet and exercise way to go, even tho I've tried all that. Needless to say, she wasnt supportive at all! So, now I'm looking for a PCM that will approve my request either on or off base...wish me luck!!

[Stay_Tuned 0]

We are stationed at Offut AFB in Bellevue NE.

My PCM was sooooooooo supportive..... I am just in awe at how many PCM's will not refer to see a surgeon.... he and I talked about the different things I had done to lose weight and how I am currently active (work our 3-5 times a week) and he said he believes in preventative medicine and his thoughts were that is what the Lap Band would be for me....

Is there a surgeon on your Base that you can talk to?? We have a general surgeon that I spoke with prior to meeting with my PCM.... he did my gallbladder removal... so at my 3 mos check up he and I spoke about WLS and he told me to not going with bypass and to wait and see if Tricare would cover the Lap Band which he was supportive of for me to have done.....He had done lap bypass surgery while he was stationed in Germany... and he asked/advised me to not go ahead with that surgery... When I went to my PCM with that information he was more then happy to help me with the referrall.....

I am so sorry you have to deal with a doctor that is so close minded....Keep up the fight! Arm yourself with knowledge.... and present it to him/her..... Sooner or later you will find one to help... or maybe give in... I WISH they would just allow the correct person... The bariatric surgeon make the decision on if it is right for you or not...

Keep us posted!!!

[aculberg 0]

Thanks so much! I think I will make another appt to see another PCM on base, maybe a civilian doc, as I think they arent so strict. I'm wondering if I contact a wls center, if they'll give me the names of some supportive pcm's that have a history of referring?! I really want to get this going, I do have a seminar scheduled for May 13, which cant come soon enough! lol

[MrsMAJL 0]

Just joined the board and thought I would send a quick message on my experience with Tricare. I started the process on Feb. 21st with a referral to a bariatric surgical center from my PCM. Had my consultation appt. at the center on March 4th and was approved by Triwest 6 days later. Tricare really does get those approvals out quickly.

I just had my surgery 4/18/08 and lost 17.4 pounds in the first week. I feel really fortunate that I was able to get approved and have surgery so quickly. Feel free to contact me if you have any questions about my experience and good luck.

[klsanders2387 0]

Ok I too am just starting th process. I see my surgen for the first time tomorrow. I am wondering what the triwest criteria is to get aproved. I am 100lbs over weight and a BMI of 40 even, however I have no comorbitities. I am wondering if I am still a canidate? I am pretty much at a loss if I don't get this surger. On 3/1/09 I was in a MAJOR car accident and I broke my back in 13 places. My physcal therepst wants me to get this done because he is afraid if I don't get the weight off, my back won't heal...what do you think? DO you think they will aprove it? Thanks for all of the advice everyone!

[chatty826 4]

I am starting the process too. I think I will have no problem getting approved through Triwest. I am 334# 5'6" with hypertension and currently set up to do a sleep study. That said I am worried about getting the consult. Has anyone heard of people getting denied for a consult if their PCM referred them?