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

Tricare Approval or Denial??



Did you get approved by Tricare?  

7 members have voted

  1. 1. Did you get approved by Tricare?

    • Yes, I got approved. No problems.
    • Yes, I got approved and I was borderline the weight requirement
    • Yes, I was approved, only after I appealed.
    • No, I was flat DENIED.
    • No, I was denied and I did not try to appeal.
    • No I was denied, even after appeal.
    • I am waiting on approval.


Recommended Posts

That is so awesome !!! I start my 2 week pre-op diet on the 26th coming up soon !!!

Can't wait fo rmonday to find out about my surgery date. I wonder how long I will have to diet. Good like on yours.

Share this post


Link to post
Share on other sites

KarinaM

I am soooooo happy for you !!! I know how hard it is to get denied !!! I am also getting Gastric Bypass.:laugh:

Share this post


Link to post
Share on other sites

KarinaM

I am soooooo happy for you !!! I know how hard it is to get denied !!! I am also getting Gastric Bypass.:tongue_smilie:

Thank you so much. I got my letter from Tricare today and now I realy believe it will happen. Can't wait for monday to schedule the surgery. I ALWAYS wanted to get the Gastric Bypass but I was going to Mexico to pay for a LapBand if I as not approved. I was very tired of fighting with Tricare...

Share this post


Link to post
Share on other sites

I am so happy for you - I hope you can not detect the raging jealousy!!!! I know how much you want this and I am truly happy for you. I got a letter form Tricare also on the 19th - but mine was to say that basicly they needed me to resubmit EVERYTHING!! So off to the clinic - agian, wieght, height, bone structure....... faxxed it to her - again!! Of course she said it will be a few weeks before I hear anything - I am sure that they will take more than a few weeks and then they will need something else!

Enjoy your Christmas. Have one last piece of fudge or fruit cake which ever is your passion!

Don't forget to shop all the winter sales for severl size smaller - so you will have new clothes for cheep! 75% of an expensive size 10 sweater, or coat. My friend Lisa says she is always cold now - less insulation!

What will you new years resolution be?

Again, I am sooooo happy for you ( and SOOOOO jealous!)

Share this post


Link to post
Share on other sites

I am so happy for you - I hope you can not detect the raging jealousy!!!! I know how much you want this and I am truly happy for you. I got a letter form Tricare also on the 19th - but mine was to say that basicly they needed me to resubmit EVERYTHING!! So off to the clinic - agian, wieght, height, bone structure....... faxxed it to her - again!! Of course she said it will be a few weeks before I hear anything - I am sure that they will take more than a few weeks and then they will need something else!

Enjoy your Christmas. Have one last piece of fudge or fruit cake which ever is your passion!

Don't forget to shop all the winter sales for severl size smaller - so you will have new clothes for cheep! 75% of an expensive size 10 sweater, or coat. My friend Lisa says she is always cold now - less insulation!

What will you new years resolution be?

Again, I am sooooo happy for you ( and SOOOOO jealous!)

THANK YOU!!!!! You are so sweet and please don~t worry about the jealousy because I understand. I~m sure things will work out for you just DO NOT GIVE UP and do WHATEVER it takes to get approved, I did. Please keep me updated and GOOD LUCK.

Share this post


Link to post
Share on other sites

THANK YOU!!!!! You are so sweet and please don~t worry about the jealousy because I understand. I~m sure things will work out for you just DO NOT GIVE UP and do WHATEVER it takes to get approved, I did. Please keep me updated and GOOD LUCK.

I am "supposed" to hear something within two weeks - I am sure it will be closer to 3-4 weeks. I am going to start another diet on the first - I am going to do a pre-op protien diet. If it doesn't work out I plan on starting Weight Watchers - I believe it is the only diet I have not tried.

Good luck - I hope you will be happy with your new life style and body!

Share this post


Link to post
Share on other sites

So I've talked to tricare and my paperwork has been received but still pending............hopefully i'll know something by Wednesday, they told me to call back at 7am..............I totally forgot Monday was a holiday.:ohmy:

Share this post


Link to post
Share on other sites

All I can say is stay on it call back - call back and oh call back. make sure they know you are there and don't let them forget about you!

Share this post


Link to post
Share on other sites

Well, the doctors office called me back and discussed a little about my thyroid and lipid panel. I already know I have hypothyroid, but I haven't been very good at taking my thyroid pill in the last 2 or 3 months. We've been getting ready for a move then home for christmas for 3weeks then actually moved and have been remodeling for approx 4wks. So needless to say I've done badly. My thyroid is off the charts apparently......or "really really really bad" is what the nurse on the phone said.........and my cholesterol is 278. I already have an appt. on Wednesday.....she said that my doctor would discuss things in more detail then but for now i should buy some fish oil. She said that I should loose some weight, WELL DUH!!! I went in for a lapband consult, no shit, I know I need to loose weight. I'm sure the lady on the phone didn't know that though............I just keep thinking this is a bad sign and they are going to tell me that they are going to stop the referral process or that I need to wait 6months to have the surgery......I can't wait........hubby is going to Afghanistan in May........and no one else is able to help me take care of our kids while I have the surgery. Geeez I hope she doesn't tell me that..............

Share this post


Link to post
Share on other sites

OK, so I called tricare north this morning to check on my referral........and they said my referral was approved for up to 5 visits with another doctor. I don't understand. I thought that my pcm put in the referral for the lap band surgery. I'm so confused.

Share this post


Link to post
Share on other sites

OK, so I called tricare north this morning to check on my referral........and they said my referral was approved for up to 5 visits with another doctor. I don't understand. I thought that my pcm put in the referral for the lap band surgery. I'm so confused.

Hi, this is what will happened. You go to your PCM and she will request a referal for you to see a surgeon. When you see your surgeon (usually they gove you 5 visits) he will request a few things like pscy eval, nutricionist, sleep study and blood test. After this is all done the SURGEONS office will submt your paperwork to Tricare to have the pre authorization for your surgery approved.

Let me know if you have more questions because I went thru this whole thing and had to fight Tricare for 6 months for approval. KEEP GOING and Good Luck.:mad2:

Share this post


Link to post
Share on other sites

Well I found out what happened.........tricare approved me for a surgeon that DOES NOT do the surgery. Go figure right? I talked to my PCM and she said that not many people around here do it, and thats it's still relatively new around here and NO ONE in jacksonville, NC does it at all. I have to go to Wilmingon or Greenville.........and I think greenville is in SC if i'm not mistaken but there may be a greenville nc. Anyway, she is having the referral specialist fix it today and they will give me a call. She thinks I'm a perfect candidate for the surgery.........BTW they checked my thyroid (since I haven't taken mine in a couple months, big mess anyway) and my thyroid was 30........30!!! so any of you that know anything about TSH levels know that's HORRIBLE.........hopefully i wont feel so drained after I start my new dose today :lol: How is everyone coming along that has been banded recently?????? Anyone having problems??? I hope all is well, and FYI they have some cute icons on photobucket for lapbanders!!!!:eek:

Share this post


Link to post
Share on other sites

Can't wait fo rmonday to find out about my surgery date. I wonder how long I will have to diet. Good like on yours.

Hi Karina,

I am just wondering what you think about my situation. I have Tricare standard and am wondering if you think they may approve a BMI of 37.4 with sleep apnea, hypertension, high cholesterol, and hypothyroidism?

Share this post


Link to post
Share on other sites

Hi Karina,

I am just wondering what you think about my situation. I have Tricare standard and am wondering if you think they may approve a BMI of 37.4 with sleep apnea, hypertension, high cholesterol, and hypothyroidism?

I wonder what scale/chart that Tricare uses to determine if you are 100 pounds over weight?

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

    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 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

    ×