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

Will tricare approve me (comorbidities)?



Recommended Posts

I don't have full blown diabetes but I have pre-diabetes. I was on metformin until I got pregnant and then I was breastfeeding for a year and couldn't take the medications.

Now I am getting back on metformin and also cholesterol medication but I know high cholesterol isn't a comorbidity. I had gestational diabetes during pregnancy and was insulin dependant even though I followed the eating rules perfectly. My dad has diabetes and I'm sure I am headed that way eventually if I don't do something about it.

I have a feeling though I am going to get denied. Any thoughts?

Share this post


Link to post
Share on other sites

What is your BMI and where are you located. If there is a MTF that dose Lapband all you need is your Dr to send a referal and BMI over 40. I have triwest my self. I have not been banded yet but I have got everything started.

Share this post


Link to post
Share on other sites

I'm just under BMI 40. Weigh me in my clothes and I'm probably at 40.

I'm not near a MTF. I'm near Groton CT and was referred to Yale New Haven Hospital, which I haven't been seen there yet because I'm still working on my requirements and being held up by the long waits for appts.

Share this post


Link to post
Share on other sites

Now I am getting back on metformin and also cholesterol medication but I know high cholesterol isn't a comorbidity. ?

I would think hyperlipidemia would be considered one. did your doctor say this or Ins Co?

Share this post


Link to post
Share on other sites

I have Tricare Prime and I have been approved for my surgery Feb 12th...I am a diabetic and BMI is 37 and my cholesterol is slightly elevated so they considered me as having 2 comorbidities...Good Luck to you! I got my approval in 4 days once I met with the surgeon so Tricare is pretty quick and I think they are approving a lot more people now! Good Luck!

Share this post


Link to post
Share on other sites

Tricare is great they don't make you go thru as much as other insurance company so your wait isn't as long plus you get your approval back in as little as 2 days. The biggest hold up for me is that my Dr is booked up until May so my date is not until May 19. Just make sure the letter your PCP writes he puts in everything that is going on with you that is a big thing with Tricare. Good Luck

Share this post


Link to post
Share on other sites

I was denied by Tricare twice! I figured out that the paper work was not complete. Your records must state that you are 100 pounds overweight - and they have to have you body frame in there - mine did not so I was denied. Remember it does not go by your BMI it goes by the MetLife weight scale for your body frame and height. The comorbities are pretty easy - if you have them and are on meds or special diet because of them - then they count. I just got approved and it took me 6 months!!!

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

    • 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.
    • 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.
      · 1 reply
      1. BabySpoons

        Amazing! Congrats!!! Watch out for the sharks. 🦈

  • 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

    ×