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Tricare Standard - Trying again

About a year ago I went through the process and was denied because my comorbidities weren't severe enough. So I tried diet, excercise and to at least maintain. However I've gained about 15 pounds which puts me at the low end of being 200% over. Lack of energy, lack of self esteem, joint pain and GERD has of course gotten worse with the weight gain.

I go in one week from today to reweigh and update H&P and resubmit. I'm currently on prednisolone for an allergic reaction, so hopefully that weight gain will come into play before my appt. Tuesday.

Wish me luck!

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I am glad that you are trying to get approved again. I have Tricare Standard and I was approved in less than 48 hours. I am 100lbs overweight and have a MILD form of sleep apnea. If you do not have any qualifying co-morbidities, have you surgeon order a sleep study. The results of the sleep study helped me to qualify for the lap-band.

Good luck to you.

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I am glad that you are trying to get approved again. I have Tricare Standard and I was approved in less than 48 hours. I am 100lbs overweight and have a MILD form of sleep apnea. If you do not have any qualifying co-morbidities, have you surgeon order a sleep study. The results of the sleep study helped me to qualify for the lap-band®.

Good luck to you.

I never had the sleep study done. But I've noticed since my weight gain, I can feel how heavy my chest is and just rolling over in bed can make me breathe heavy. :tongue2:

I'm hoping for approval but would do the sleep study if it would get me qualified. The arthritis in my knees wasn't bad enough, blood pressure not high enough and I'm not diabetic. So at 100lbs overweigh my co-morbids weren't severe enough. But now I'm closer to being 200% over, so hopefully I won't need the comorbids.

Yes, get a sleep study. I had one and ended up with a cpap. I don't really like the cpap, but I sleep tons better.

WLS is excluded from my policy, so it didn't matter what I had. I must say, my GERD is a lot better with the band too, which is the main reason why I got it. Even if I get skinny, GERD will still be there. Hopefully still controlled to a point by the band.

Good luck and let us know what happens.

Can someone please tell me if Tricare Standard pays for the surgery, and more importantly HOW MUCH? I've found information on Tricare Prime, but we're standard. I'd love to pursue this is they pay!

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