Tricare approvals

Hi, I was just wondering what your experience with Tricare has been? I am 5'3 and 229 BMI 40. I do have arthritis in my one ankle, have degenerative disc disease in my neck and am pre-diabetic. Just wondering what you think about my chances for approval? I also am considered disabled through the VA (I am a vet, for migraines, and my arthritis, etc). I am also tricare standard (best decision I ever made in regards to doctor choices) I am near St Louis now

Thanks for your help. Are you glad you got it or are getting it?

Heidi
heidshosh@aol.com

Hi Heidi, I have tri prime and I am diabetic high blood pressure, I don't think you will have any problems with approval from your standard. I also agree that the TRICARE INS is the best I have ever had. I am glad I got the surgery but I have been a very bad patient. I have not lost alot of weight but it is truley all my fault cause I have self esteem issues that I need to work on. Some days I am good about what I eat some days not so good. I am addicted to popcorn and cheese puffs lol. So good luck and let me know how you do. I live in SC my husband is also 100% VA disabled. He is retired from AIR FORCE.

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Surgery Date: 08/21/2008 8:30 am

anyone know if TRICARE PRIME pays for tummy tucks?

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Surgery Date: 08/21/2008 8:30 am

I had surgery in 2007 before Tricare standard approved.. then when they approved, they reimbursed me for the hospital visit (but not the doctor). I believe you'll be covered and do fine.

Thread Starter

Thanks for your replies. Are you glad you had the LAP-BAND®? What has your success been like? Do you wish you had gastric bypass? Thanks so much Heidi

very glad I got my band. my dr would not agree to let me have the bypass.I was a little afraid of that one myself. have always wanted the LAP-BAND®. now I just need to get my head around it:) but you should have no problems with tricare. also there are more success stories than not.

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Surgery Date: 08/21/2008 8:30 am

I have Tricare Standard and I am waiting on my approval. I had no big secondaries (like diabetes) but was approved by the surgeon because I am 200% over my ideal body weight. I haven't received notification of the costs and haven't even asked yet. I am sure you know that if you call three different people on the same day at Tricare, you will get 3 different answers. Add me as a friend and I will update you on the approval process via my profile. :)

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Surgery Date: 11/30/09
Presurgery Weight: 329 lbs


Created by MyFitnessPal.com - Calorie Counter
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Well, I'm sure that means sumpthin'--Gladys Hardy
http://www.bettysoutherland.com

@carolynfletcher:

You're the first person I have seen who hasn't lost quite a bit of weight in the first year with the band. Did it not work for you? Why do you think it isn't working? I am just curious and asking questions because I haven't gotten mine yet and want to be aware of possible problems and things to look out for.

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Surgery Date: 11/30/09
Presurgery Weight: 329 lbs


Created by MyFitnessPal.com - Calorie Counter
___________________________________________
Well, I'm sure that means sumpthin'--Gladys Hardy
http://www.bettysoutherland.com

I have Tricare Prime and had my LAP-BAND® put in almost a year and a half ago and have lost over 160 and I'm at goal. Best decision I ever made and Tricare paid 100%.

Someone asked about Tricare paying for a tummy tuck, so I'm answering that from my experience. Tricare paid for mine 100%, but I was also having surgery to have my port reposition and tacked back down. My port came loose soon after my original surgery and it was never a problem until recently. I was moving all over the place and would also wind up near my waistband causing pain. Anyway, since they already had to go in to fix that, my doctor asked me if I ever thought about having it done. Of course I said yes, but I didn't think it was covered. He told me that since they were already going in that it could be done at the same time. Long story short, mine got covered because I already needed to have surgery. My suggestion to everyone would be to have every little spot, rash, etc. documented (no matter how small) by your doctor. That way when the time comes to start talking about having a TT done, you have documented proof that you are having issues with excess skin.

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I lost 18lbs and I have had 3 fills. My 3rd fill just did not seem right and I should have went back to the dr but we went on a cross country vacation and I threw up everytime I ate so all accross country and 3 weeks there and back I lost 6lbs(that is with the 18). Some days I have restriction some days I have no restriction.I have not lost a pound in year. My main bad habit is I loooove cheetos and popcorn. Also most of the time when I throw up I just go and eat something else. I know it is in my head and that I need to go back to the shrink. I have an appt with my surgeon next monday the 19th, will let you know what happens. go with your plan for the LAP-BAND® I do really think you should do it>

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Surgery Date: 08/21/2008 8:30 am

Popcorn is not necessarily evil, unless it's drenched in butter, cheese, etc. I have popcorn all the time and it actually goes down well for me. It's a pretty good whole grain snack.

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I have Tricare standard. I had no problems getting approved. My surgeon submitted the paperwork and it was approved in less than 48 hours.

Wt: 214
Ht: 5'6"
Comorbities: Sleep Apnea (very mild, no CPAP).

I don't think you will have a problem. I haven't been banded yet....2 weeks to go.

Thread Starter

Thanks again for sharing your experiences. I have my first appt on the 23rd. I am not sure what to expect, if I get bloodwork then or what... what usually happens? I am getting mine done in St. Louis.

Take care
Heidi

I am a Tricare bander and have never looked back - on a side note, see below!


Tricare is proposing new regulations in regards to LAP-BAND®®® and other weightloss surgeries. This is a good thing. They want to use BMI as a means by which to assess acceptance rather than just "100 pounds over weight". Until December 28th they are requesting comments for this change. All you have to do is go to
Regulations.gov and then click submit comment towards the center of the page to leave your thoughts. You don't have to give all the address and govt agency info unless you just want to, that's just voluntary extra stuff.

For more info on the topic check out page 14 of the November 16th edition of the Navy Times. It's in the section titled FastTrack.

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Thread Starter

Thanks so much! When you went to your first consult with your doctor what did you take with you? Like someone suggested my family practice doctor write a letter for me... I have never seen the same doctor while I lived in NJ for more then two times, and really my OB GYN knows me better then anyone... I do have tons of medical records from things that happened in the past, surgeries (joints), diabetes when pregnant - lost child, I get Veterans benefits because of a neck injury while on active duty in which I have degenerative disc disease in my neck... Anyways - not so share all that with you but I am hoping it helps my case to get approved. I am 5'3 and am at 228... so I am right on the line of the 100 pounds.

The doctors office said Tricare needs 6 months of a diet - I have been a member on weightwatchers since July (many times over) online. But I don't have every week weight out... is this a problem?

Thanks for your help and advice. Do any of you have blogs or pictures?

Heidi