I just got the news from Tricare today that I have been denied for the Lapband.

I'm really upset about it because it was something I was very much looking forward too, I even saved some of my "skinny jeans" just incase I would loose the weight.

They denied me because they said my co-morbidities were not severe enough. I have Polycystic Ovarian Syndrome, Plantar Fasciatis and Arthritis in my knees. But that's not good enough. Even though I wake up in the morning and can't walk because my feet hurt (the fascitis), it has to get bad to the point where I would need surgery for that before they would approve me. Or I would have to contract Diabitis from the Ovaraian Syndrome. Or IDK...have my knee amputated above the knee before I can get the Lapband. I'm so mad right now I'm typing fast and I know I just misspelled like 8 words in there.

I am 110 lbs overweight, in very much mental and physical pain because of it, and they don't see it! Supposedly I have to wait a min. of 6 months or even a year before I can reapply.

But the worst thing of all is dealing with my anxiety about my husband seeing me (with all the weight I've gained since he deployed) and not being attracted to me. It's enough to make me go insane.

I have plantar Fasciatis also, excrutiating until last summer doc made me a heal insert for my shoes. I got the one I could exchange in different shoes and it has been amazing.. I know a lot of other people have tried the night splints, cortizone etc.. I did too, this is what works and is still working for me Talk to a podiatrist about making them for you, it really saved me..

I'm so sorry you were denied. It a fear we all have had at some time I am sure,, Hope there is something you can do..

hugs

When i got rejected by Aetna i took matters into my own hands and switched companies..I was lucky my employer reimbursed me for insurance...i went from aetna to personal choice (when u apply they dont ask u any questions bout bein overweight, smoker, anything) I got personal choice july 1st and i got approved july 10th! My surgery in Sept 8th..maybe u should think about switchin companies instead of self paying!

"Switching" from tri-care isn't that easy. If you are military it is standard for dependents. You can purchase secondary insurance to go along with it on your own. Dropping tri-care is a bad idea because that means you have NO medical coverage through the military.

You can supplement, but dropping is a bad idea.

I really don't understand some of the reasoning with some of the insurance companies, I have Aenta, and because I didnt have any weight related health problems, I had to document for three years that I had seriously tried to lose weight on my own, so I had to submit years of doctors reports, prescriptions and gym memberships, and after a year and a 1/2 I was approved, but other I know with Aetna, were flatly denied. I would switch health insurance if possible. I have been told that BC/BS has not been giving people a hassle

Forget part of the last post I didnt realize that tri-care was from the military. So financing may have to be an option

Kstate...did you call Tricare to see why you were denied??

You can still get another insurance. Tricare will always be secondary though.

Definatly Appeal! A secondary insurance wouldnt hurt but appeal the origional even if you do get a secondary one.

Hmm..that really sounds odd. I have never heard of Tricare denying people who are 110 lbs overweight.

Get to the bottom of this denial. Be strong and demand to know why they denied you.

Something sounds fishy.

Go through belite weight. Call Jessica. Have the surgery done in Juarez Mexico with Dr. Rodrigues. He is the best and it only costs about 8000 thousand dollars. I know it is still a lot but way less than in the states. Plus he has done more lap band surgeries than almost all US drs. Think about it, plus you don't have to jump through hoops. Your husband loves you for you. He will understand and support you on your journey. It's really important to have your husbands support during this time. Good luck and hang in there.

I am setting myself up for denial as well...I am so sorry you were denied, but as other people have said....appeal appeal appeal. I haven't even submitted to the insurance co yet, but I am also preparing for an appeal so I will be ready. I have Cigna and many of the same co-mobities as you...ie: fallen arches (I have even had surgery on one foot...I would NOT recommend it) Gerd, herniated discs in my back (that I have an MRI for) severe knee and joint pain, high cholesterol, elevated blood pressure and stress incontinence. My problem is my BMI is low at this time from dieting...I just know I am the queen of yo yoing and it is already starting to come back. (gee and i thought i left it on the highway....lol) Please do not give up and trust me it is easy for me to say, but since I have put all my eggs in the "lap band" basket I will feel just like you.....God Bless Kimberly

where do you have your fills if you have your band placed in Mexico?? Who do you go to for follow up appts??

Appeal the decision! Bottom line is that insurance companies don't want to pay, ever, which is why they're so rich! If you hound them enough and they realize you won't back down, I would imagine they will approve you.

I have my fills done by my Dr in Anchorage Alaska. There are fill Dr's all over the US. Some won't do fills if you didn't have surgery with them. But you can always find a Dr somewhere that will. Fills are so easy I could do one myself if I had the equipment.

aetna ins & 90 day supervised diet ((( please -help me )) iam confused

i am doing the 3 mo supervised diet with my family doc and he's telling me to walk 30 aday and eat better and there saying to write down everything i eat and do for the 90 days so my question is am i to really lose weight on this ???? or just do my appt.s and write everything down from exercise to eating ????? anyone know the answer iam in ohio thanks in advance ... love this site:)