military insurance?

does anyone know anything about tricare? My husband is active duty and the website says that you have to be 100lbs overweight and have diabetes or some other syndrome. well, I am just overweight. I am 5"4 and I weigh 230lbs. I am at a point where I don't want to get any bigger. I have tried diets and exercise but they didn't work. I was just wondering (if anybody knows) what my chances are of getting a referral to get the surgery with just being severly overweight...


Thanks for any comments!

Kim

My DH is also AD and I have Tricare Standard. This is the information off of the Tricare website about Lap Band. You can also call their toll free number and speak with someone. They are very nice and helpful.

TRICARE covers gastric bypass, gastric stapling and gastroplasty to include vertical banded gastroplasty and laparoscopic adjustable gastric banding (Lap Band surgery) is covered only when the beneficiary meets one of the following conditions:

• Is 100 pounds over ideal weight for height and bone structure and has one of these associated conditions: diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome, hypothalamic disorders or severe arthritis of the weight-bearing joints
• Is 200 percent or more over ideal weight for height and bone structure
• Has had intestinal bypass or other surgery for obesity and because of complications, requires another surgery (takedown)

Good luck, my DH is retired and I have TriCare standard. I was 100 pounds overweight, but had no co-morbidities. I went to Mexico. My husband has Medicare and TriCare For Life and is just starting the process to get approved for this surgery. Seems to me more insurance companies would want us to be proactive with this. Why wait until we have those co-morbs and have done the yo-yo thing for years, and cost them thousands more in health care costs!?! Maybe in a few years they'll come around. Good luck! I hope you can get approved.

Grammylew. Did you go to Mexico and pay "out of Pocket" ?

Yep. Tijuana, Dr. Ortiz, $8500, my daughter paid for it. Consequently if I have complications I would also have to pay for it myself, either here or in Mexico. I get fills at Fill Centers USA.

I just found out late January that since my hsuband is retired Army we are eligible for Tricare Prime which pays almost all of the bills for the surgery. You still have to meet their eligibility requirements and you have to go to one of the doctors on their eligible list, but thankfully mine is. You might check it out and see if you are eligibile for the Tricare Prime. BTW. it was only $115 per quarter to upgrade the insurance.

I am retired Af. I have TRI CARE PRIME. I was banded on Feb 11 08. My portion of the surgery was $12.00. You really need your military dr to give you a strong referal, to make it easier.

Check out the Insurance forum on here - we Tricare people have been posting like maniacs since it became an approved procedure. You may find some of your answers! Good Luck and keep us updated!