Tricare Prime-under age 25 please help!!

[Lilpeach_059 0]

Ok, I have Tricare Prime, and I need to know what is your "ideal weight" if you are under age 25?? Im 22 years old, and I think I meet the 100lbs over, and I had my PCM write a letter for joint pain, recurrent abcess and asthma. I wanted her to write "severe arthritis of weight bearing joints" but Ive never been diagnosed as that.

Tricare says they dont use the Metro Life chart (which is for individuals 25-49 years old)!! They (Tricare) said the surgeon has to say that it is medically necessary!! (Yea I know that but what ideal weight does Tricare use?) Ive spoken to a handful of reps and Im tired of calling! :w00t:

Someone please help, any advice is appreciated. I know I can just have the packet submitted, but I dont want to get denied! :blushing:

[Lilpeach_059 0]

Approved!!!! In a matter of hours!! I was worried for nothing!! Im 5'5 (had my PCM put 5 4and1/2), starting weight was 241 and like 256 (been on this road for a while) but I dont know which Tricare considered. Also had PCM write letter saying joint pains, asthma and recurrent abcess. Then I had the stuff that the surgeon made me do (psyc, pulm and nutrition consult and seminar and TSH level). Cant wait till im banded!!

Also my labs and consults were 1 and 1/2 years old!

[talkalot1981 5]

Did you get approved to have surgery or approved to just see the surgeon? I have a surgery date of July 28th, wish it was sooner but at least I have a date....Jennifer

[Lilpeach_059 0]

It says "Lap place gastr adj dev."

Place of treatment : (the hospital that the surgeon works at)

Case Type :Evaluate and Treat (and other services)Submitted Date:06/18/2009Approved Date:06/18/2009Type of Service:Bariatric surgery outpatient

one visit

So hopefully this is a yes!!!!:thumbup:

[Iris_L 0]

It says "Lap place gastr adj dev."

Place of treatment : (the hospital that the surgeon works at)

Case Type :Evaluate and Treat (and other services)Submitted Date:06/18/2009Approved Date:06/18/2009Type of Service:Bariatric surgery outpatient

one visit

So hopefully this is a yes!!!!

Yes you were approved so now you can update all of your dates!!! :tongue: God Bless!! and congratulations

[Lilpeach_059 0]

Thank you sooo much! Same to you!