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I am Tricare prime and have been trying to get through this journey. I started talking to my original PCM about four months ago. He kept trying to discourage me and tell me to diet and exercise. The doctor I work for is a weight loss specialist so he did this great diet plan for me and I gained weight. I went back to my PCM and still wasn't getting anywhere. I switched to another doctor and on the first visit he ok-ed me to meet with w/ a WLS.

I wasn't comfortable with the surgeon Tricare sent me too, so I did a free consult with another office. I am 103lbs overweight. I have HTN and knee pain. I am 5'11 and 244lbs. I qualify and the surgeon said it shouldn't be a problem. I had my EGD, EKG, U/S and Blood work done. My referral was sent to Tricare about two weeks ago....with no answer. I called and they won't even tell me anything.

Anyone else have major problems with Tricare?

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I followed my authorization request online and it only took 4 days. Good luck to you and dont give up!!

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I'm Tricare standard. I had to use a "Center of Excellence" surgeon. He's head of bariatrics at a local hospital and they had someone (thank you Nadia!) do all the paperwork for me. From seminar to surgery was 1 month and my approval took about 48 hours.

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I have Tricare Prime as well. From the time my paperwork was actually submitted, it was about 4 days to approval. Could your paperwork have been sent in a little later than you think and that's causing the delay?

Hope you find out something soon. I know first hand the waiting is one of the hardest parts.

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We have Triwest (prime) and took 4 days from when my surgeon sent the request. I hope for an answer for you soon!

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i had a HUGE debacle getting tricare to approve my surgery. i ended up calling them everyday or every other day for 2wks and FINALLY they answered me. I have no clue what the hangup was. I have tricare prime and felt like they dragged their feet, also i dealt with some liason between tricare and my surgeon at healthnet federal services that was IDIOTIC! the day before my surgery they called to ask me if i was sure i wanted to have my gastric bypass. I was like ummmm NO i'm not having bypass!! and i had to argue w/her for a few moments until they finally believed me.

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AHHHH! So I can been calling Tricare and my WLS office for the last two days. I finally got through to someone at the WLS that had some knowledge of what was needed. I got their fax number and called Tricare back because they needed to know what Fax number the auth request was coming from. Turns out they never faxed it in!! So I call back to the WLS office and they argue and say they did and they will fax it again. They still have not faxed it! I am so pissed and angry I started crying....

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So It's finally listed on their website. For some reason the follow up care and fills got approved just not the actual surgery yet! Can you believe that?! HA. Wish me luck!

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Good for you! You've had a dreadful time! Now you get to be excited!

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Tricare was very fast for me. They faxed the letter on 4/29 and I had my approval online 4/30 and my surgery on 5/12.

When all else fails with tricare, call and ask for a case manager. Things will get done much faster with someone you can specifically call and contact.

This was the first time tricare was so easy.

Watch out though - if your surgeon typcially does surgery with an assistant or two....you might get denied after the it is done.

They require TWO Surgeons during the procedure.

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    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.
      · 1 reply
      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.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

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

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