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Tri Care and the Phych Eval...Does it cover it?



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Ok I just had my 1st consult witht he Dotors office..Got my information or my Physc Eval...But I called them and they do not take Tri care...They said I am the same as having no insurance to them and it would cost me $704 to have the eval done.....WOW... I don't have that kind of money. Its all I can do to come up with the $398 program fee for the Dotor as it is. Wonder will the doctor allow me to go to a Phych. that is covered by my insurance.

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I have Tricare Prime (South) and did not have to pay for the Psych Eval. My PCM gave me the referral for the Psych Eval. You might see if that would make a difference. I did had to pay $75 today for the nutrition appointment. I have been told that the $75 and $12 copays is all I should have to pay for the whole thing.

Tricare can be very fickle. Several providers choose not to accept it because of that reason.

Hopes this helps.

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I live in Washington State and all of the places here that do LapBand surgery refuse to contract with TriCare. They told me that TriCare barely pays out enough to cover the cost of the band itself let alone the surgery and the annesthesiologist (ss for sp). I applied for CareCredit. It's just like a credit card, but just for medical expenses. My surgery cost a little over 16,000 dollars, but has been oh so worth it!!! Good luck and I hope everything works out for you.

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you can get a eval through a network provider for tricare and take that to the surgeon to cover that. i was lazy and did it through the doctors office and paid 150 for my eval and 60 for my excerise consultant so that way i get it over in one shot.

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you can get a eval through a network provider for tricare and take that to the surgeon to cover that. i was lazy and did it through the doctors office and paid 150 for my eval and 60 for my excerise consultant so that way i get it over in one shot.

If the eval was only $150 I would do it that way...But this doctor wants $704 to do it. OUCH!

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Will Tri Care require you to have been a 6 month supervised weight loss program?

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I have paid absolutely $0 for any of my surgery, pre-op stuff, fills, program fees, etc. I used the base hospiatal nutritionist for my nut eval and called ValueOptions (they are contracted through Tricare South, not sure about other regions) to find a pysch who would do my WLS eval.

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I'm actually going through the process of getting my psych eval approved by Tricare. My surgeon's office is taking their sweet time sending off the referral. Im sure Tricare is going to cover my Psych Eval and if they don't, I can pay $150 dollars to my Surgeons office and have a Psych Eval done through them. I wish you the best of luck!! :sad_smile:

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yeah if they wanted to charge me for an hour worth of work for 700 buck i would go find a network doctor and bring it in.

no there is no 6 month diet on tricare you just have to meet the requirements

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I have Prime and I haven't paid one red cent for anything except my initial doctor's visit, which cost me a whopping $25. I got my PCM to refer me to psych, so that was covered and I went to the military nutrisionist, so that didn'tcost me anything, either.

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I have Prime and I haven't paid one red cent for anything except my initial doctor's visit, which cost me a whopping $25. I got my PCM to refer me to psych, so that was covered and I went to the military nutrisionist, so that didn'tcost me anything, either.

I just called my PCM yesterday and asked them if they could refer me to get my psych eval done, because I thought they could get me a referral much quicker than my surgeon would. However, they told me that my surgeon has to be the one to refer me. :eek::thumbup: His office sure is taking forever and its frustrating me! I want to try and get this done before Christmas gets here!:eek:

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That's awful. My PCM did my referral for me, but she has been pretty helpful with anything I've needed. I'd call and beg.

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Yeah it was the secretary that told me that. Maybe I need to just schedule an appointment with my doctor and then ask her personally when I see her?? LOL

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I would- it's harder for someone to say no in person. Try to get his/her direct number, so you can call for any more stuff.

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I asked the surgeon if I could get my nutrition and psych consults done on post and he was fine with it. I had an appt with my PCM to get prescriptions refilled and just asked him to put in the psych referral for me. Within a couple of days I had the approval from Triwest to see a network psychologist. The name they gave me was booked until Nov so I just started calling and got another one in network and got my appt a couple of days later. All I had to do was call Triwest and tell them the new name of the dr and they changed the referral. If I had used the Nut and psyc that the surgeons office works with I would have had to shell out about $750 and then try and see if it was covered. I didn't have that money to put out so I was glad my surgeon was so agreeable.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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