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I'm prime and didn't have to pay anything..and we are in Alaska,so a lot of the tests i needed i had to go into town to get...

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I'm tricare prime. Approved within a week. My surgery date is Sept 16...so i'm getting nervy :w00t:...I got the referral to see the surgeon from my pcm end of july...so process has gone very quickly for me...I did have to pay out of pocket for a few things...the surgeon i was referred to has a diet and psych that does not bill insurance, so those appts were 200 ea, and the surgeon would not let me see anyone on base for those. The only other thing I'm spending money on are Meal Replacements and stuff like that. wish me luck...ive never had surgery and if they made a stronger word for terrified, i'd use it...:w00t:

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SOunds like the dr. I dumped last year...felt like I was part of an infomercial everytime I went there....see OUR Physch, see OUR lab, see OUR physical therapist, and BUY OUR meals and shakes....NO thanks....then to boot the Dr. could have used his own surgery.....

Thankful I found the new guy and will be having surgery someplace I feel more at ease next week.

I have 15 major surgeries in my life...so that does not worry me as much as dealing with my insulin issues!

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Hi! I was banded on Aug 25th as well. Just recovering - can see where liquids will grow old within 3 weeks. But I'm thrilled I had it done! Tricare has covered everything so far except $50 for the nutritionist. All in all, I can NOT complain about that.

Looking forward to the rest of the journey!

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I'm tricare prime. I was approved in one month, and surgery scheduled quickly. I have to pay $280 for the surgery itself and $12 per adjustment visit

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was wondering if any of you Tricare Prime patients have had a fill yet and if so, what did it cost you?

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was wondering if any of you Tricare Prime patients have had a fill yet and if so, what did it cost you?

I have had 3 fills so far and it cost $12, I have the fills done by xray or whatever they call it.

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I am Triwest and I just got approval last week. They did it same day! I have surgery Oct 29th. So far no expense but I still have a few tests to do. I have done consults and egd so far and those were covered.

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I also have Tricare Prime and got my approval back in 2 days. My copay for a visit/fill is $12 after the first 90 days post-op. Feel free to ask me any questions you have. I'm 9 months out and haven't had the first issue with Tricare.

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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
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