Tricare Providers in Tampa Florida

happymommxy4 · November 13, 2008

Hello Everyone,

My PCM will give me the referral but I have to find the provider first and then call my PCM who will then put the referral in. I meet the critera for Tricare approval but I admit it's a bit of a stretch of the imagination (my cholesterol is perfect, bp is great, no diabetes...etc). My PCM feels sure I can be approved though because Tricare has been known to be very liberal with covering WLS. I also have a close friend who I NEVER would have thought would qualify and she was banded back in August. Like I said, Tricare is pretty liberal with the coverage of WLS.

If anyone out there is military and in the Tampa area, who did you find that Tricare covers? I would love to have it done at Tampa General as this is right around the corner from us. We're an Army family stationed at MacDill AFB and we do not have a MTF that does any surgeries.

Also, if you're military and had it done in the Tampa area would you mind sharing what total wait time was? I mean from the day you met with your surgeon to the day you were banded how long was it?

Thank you so much for taking the time to reply.

~Sarah

Maggies · November 13, 2008

Hi Sarah, I'm not from the Tampa area, but I do have Tricare. I was denied the first time because you have to have at least 1 health issue. I was denied because my sleep study was not included in the package sent to Tricare showing I have sleep apnea. It was included the second time when we appealed it and I was approved. You also need to be at least 100lbs. overweight. Good luck and hope you get approved soon. Maggies:shades_smile:

happymommxy4 · November 13, 2008

Thank you, Maggie. I do have osteoarthritis which, as we all know, is made so much worse by obesity. My PCM back at Ft Hood said it was due to me being overweight so I believe that should qualify me in and of itself. I know Tricare goes by the MetLife scale for obesity, if you look at the bottom of the range (and I have been told they do) then I am about 110 pounds overweight. My one and only concern with that is I want to lose 70 pounds, I have been as thin as 140 pounds smaller than I am right now (in high school...lol) and feel I look best at about 70-80 lighter than I am at the moment.

I don't have sleep apnea to my knowledge and a Dr has never mentioned me needing a sleep study.

In all honesty, back at Fort Hood they were giving these things away like halloween candy. And not at the MTF either. I can think of 6 (SIX) people just out of my circle of friends who have been banded in the short time since Tricare approved coverage of the band. Maybe I shouldn't put all my eggs in this basket though. I have tried and tried and tried to get this weight off. Every time my husband deployes I gain 20 pounds despite my best efforts not to. My parents are both in the 400-500 pound range (I am 5'9" and 239). I did weight watchers and had success but to be honest we cannot afford $40 a month for WW.

Okay, enough woe is me. I am working from home as a medical transcriptionist and in the past year since I have been doing that the weight has just piled on. I was never sedentary before and now I just sit here at this computer all day and that makes it even harder to get the weight off.

Maggies · November 13, 2008

Have you went thru all the tests that are required for the surgery. EKG, Chest xray, blood work, etc. After you get all the requied tests done, the surgeon you choose will submit it to Tricare. There is a lot of hoops to jump thru beore you actually are banded, but well worth it. Once your pcm submits to Tricare for the approval to see a surgeon and it is approved they should suggest a surgeon that takes Tricare patients. From there make your appt. with him/her and the surgeon will tell you all the texts you need to have done. You will have a lot to do, but it is worth it. Maggies:shades_smile:

happymommxy4 · November 13, 2008

Either this is required by the doctor and not tricare or the ladies I am friends with have a doctor who is really pulling one over on tricare. I hate to even say this because I see what others have gone through the get this operation, but of the SIX people I know who had this done in the Fort Hood area THREE of them had it as simple as "hey I want a lap band." Ok that is an exxagerattion but they way it went was to ask PCM for the referral, the PCM did the referral stating chronic pain in joints and depression secondary to obesity. That was it. Nothing else. Next step was to attend a seminar, then meet the dr, the dr submitted the request to tricare after two criteria were met (nutrional consultation and psychiatric evaluation). Approval, presurgery meeting with anesthsia as is standard for anything, surgery. Beginning to end was 2-3 months for each. I was not just being silly when I said they are handing these out like Halloween candy in the Fort Hood area. I am not sure that is necessarily a good thing either but I am not the doctor.

Thank you again for your input. I do not think I am going to qualify if the rules are actually followed. I jogged 2 miles this morning so with a little perseverance hopefully I can get er' done without this. :thumbup:

Maggies · November 13, 2008

I think you should keep trying and see how it goes. Everything could be different there. I am in California and it was a job getting it done. But I would do it again. Good luck and keep trying, Maggies:shades_smile: