I'm SOOO excited! Tomorrow is my conultation day!!! I think I'm on the edge of the 100lb overweight mark req. by Tricare, with a couple co-morbs, also required. I'm keeping fingers crossed, toes and everything else crossed. I'm determined this is the tool I need.

Two things I'm worried about is whether they will approve the surgeon I was referred to and then, will the office staff submit everything just the way it must be to meet approval by Tricare quickly.

If anyone has the magic formula for submitting to Tricare nowadays for smooth approval, please, please, reveal what it is!!?

I've sent in all my releases, medical history, weight history for 5 yrs, weight loss attempts history for last 12 years, and I have documented asthma, stress incontinence, sleep apnea, high cholesterol, back/hip pain treated ongoing for 10 years, GERD, family history of heart problems and diabetes, BMI 42. My prelim blood labs are done, sleep test and Md referral. Attended an info session, attended a support session (req. by surgeon). Can anyone tell me if I'm missing anything??

Thanks!!

sounds like you have done it all

I'm assuming you have a copy of your insurance policy and have reviewed all the requirements. The surgeon's office (person who works with ins. for approvals) is a great source for everything you need to do. Good luck tomorrow...and weigh in 'heavy' if you're at all close to the cutoff (read HERE)...I've never heard of a '100 pound' requirement, but your BMI and comorbids seem to meet all the ins. requirements I've seen. Best wishes! -BG

I do have a copy of the requirements for my insurance and I'm going to have to apply the same strategic eating/drinking regimen to get right to the edge of qualifying weight, with a BIG BREAKFAST in the morning, lots to drink too. But it's 100 flippin degrees here so I don't think I can get away with heavily layered clothes without being sent for a psych eval for being nuts!!

Yes, Tricare goes by 100lbs over ideal wt, + comorbs or 200% of ideal wt with no comorbs. They use actual wt instead of BMI. Like any ins., make the hoops confusing enough and people and their doctors might flub up so they can deny. I read it very carefully so that I could make sure to jump through the right hoop. I've been eating, some out of stress and most because I need to make the wt requirment and I'm just plain tired of eating so much.

This surgeon's office said they hadn't had a lot of Tricare patients so weren't totally familiar. So I also provided them with the info list of requirements.

Thanks for the good wishes and suggestions. Must go consume mass quantities.... heh, heh, heh! for now.