OK, I am TriCare Prime South, going to a civilian doctor, my hubby is in the army, active duty, deployed, been in the army for about 8 years now. I am coming to ask some of you ladies who have been through this process all ready with Tricare something...

Have you had to pay different copays along the way? So far I am in the pre op testing and I have to pay $60 for the PSYCH eval, and $18 for the NURTITION eval. Does that sound NORMAL to anyone? When I go to normal doc visits or anywhere else(even when I had to go to the emergency room) I've never had to pay anything. B/c I am new to this I guess I don't get it. The patient advocate who is working with me explained that Tricare doesn't cover it, but reading through some of the threads I saw that some of you had to pay some copays and others didn't. I am not understanding why I am having to pay for this stuff when this stuff is supposed to be covered. Am I tripping or is this normal? Can someone PLEASE bring it into proper perspective for me, b/c I just don't get it.

My PCP is with the Family's Clinic in Copperas Cove. And to be honest, the main reason I chose Scott and White was so I wouldn't have to drive so far. And I can say that I did and continue to recieve great care.

So I talked to TriCare and they told me that I could use the same referral (for the surgeon in Austin)that my PCP gave me for the Lap Band that's approved by them to CHANGE my surgeon to get one closer to where I am (Temple). They said I wouldn't have to go through a second approval process, it would be the same one, they would just change the surgeon who'd be doing the surgery on it. I was actually shocked. So now here's my question for you since you went through Scott and White...how did you start? Was there a seminar you went to? If so can you let me know a number or something I could call? I'd appreciate it a lot! (I also left this message in the "Killeen" thread as well). Thanks!!

Edited September 22, 200817 yr by ArmyWife

My hubby is a Marine and we have Triwest. The process has been easy, the only drawback is the nearest provider is in Kansas City Missouri and we are in Wichita so I have to drive 3 hours one way to my doctor. Triwest reimburses us for gas and for tolls so that is a blessing too. The way I found out I had been approved is Triwest called me! I was so surprised. They also told me someone would be calling me after surgery just to make sure I was doing ok. I have to say I am impressed with them. I have not had to pay one cent for anything, the Tricare office on McConnell made my appt at the sleep clinic and I had the psych eval done on base. I went to the surgeons office for dietcian and exercise physiologist. I have had a good time of it so far and expect nothing but this in the future. I am scheduled for Monday Sept 29th

Laura

Hi everyone!

I am just getting into this "BandLand". I have been approved by my PCM and they are going to do my banding at Wright Pat Air Force Base. So I guess no out of pocket expense on my end? Has anyone had this done on a military base? My first appt. is with the surgeon on Oct 8th. How long after the first appt. is the surgery scheduled? I have heard that you have to have at least 3 pro-morb reasons to have this banding. Mine are Obstructive Sleep Apnea (CPAP), high blood pressure, high cholesteral, arthritis in knees. Need to loose 100 pounds, BMI is 39, so says my Cardio doctor, I guess this make me a candidate! My husband is retired after 25 years in the AF, been out in the civilian world for over 12 years.:smile:

My hubby is a Marine and we have Triwest. The process has been easy, the only drawback is the nearest provider is in Kansas City Missouri and we are in Wichita so I have to drive 3 hours one way to my doctor. Triwest reimburses us for gas and for tolls so that is a blessing too. The way I found out I had been approved is Triwest called me! I was so surprised. They also told me someone would be calling me after surgery just to make sure I was doing ok. I have to say I am impressed with them. I have not had to pay one cent for anything, the Tricare office on McConnell made my appt at the sleep clinic and I had the psych eval done on base. I went to the surgeons office for dietcian and exercise physiologist. I have had a good time of it so far and expect nothing but this in the future. I am scheduled for Monday Sept 29th

Laura

WOW! That IS a blessing! I have TriCare Prime and I am thankful for them paying for the sugery alone, but from the hositpal I was going through before, I would have been required to pay all these horrible copays. I have since switched surgeons (Praise God for this discussion board or else I would have never known that anyone in my area even DID banding!). So I am looking forward to not having all these copays anymore. But you have been really fortnuate. If I had all those reimbursements like that I would have stayed with my original surgeon.

Wintobethin I always thought the comorbid clause was if you had a BMI less than 40 like you do. See my BMI was over 50, so I didn't need any comorbs...I was fat enough on my own...lol. But the odd thing is, is that that's my ONLY health issue. I don't have HBP, sleep apnea, or anything else. The surgeon told me I am completely healthy to be so big. But he also said that it's good that I am getting this under control NOW. If not...I could be diabetic by the time I am 35. I am feeling it on my joints anyway, so I am starting to "feel fat," which I've never felt before. So it's time. I am glad I am taking care of this now, while I'm younger. I am having mine done at a civilian hospital...I don't mess with base doctors...lol. But don't want to scare you, I am sure the one you are going to is very competent! Congrats to you!!

My mistake, I just looked up my BMI from another appt. with weight loss clinic (through the military) and they had my BMI at 40, so I guess that one is right? My husband and I have had other MAJOR surgeries through the military (one was a breast reduction for me) and have had NO PROBLEMS with anything, wonderful doctors. I worked at WPAFB hospital years ago and when the new doc's come in they are screaned CLEAN! No crap here!!!!!!!!!