Daniboo424

Hi, I think that you and I have run into a similar situation and what I have discovered is that this company is basically ripping off military people. They do not tell you initially that you need to have a referal from a Tricare doctor because they are not within the network to be covered by Tricare. They are supposed to get preauthorization for all of their procedures before they do them, because that is what they tell you they will do before you come in, but the fact is they do not do this. They submit everything after you have already come in hoping that Tricare will approve it. As you have stated you are well within the ramification of what is acceptable for this type of surgery so you would do better to just get a Tricare doctor. Do you live in an area where you can use civilian healthcare? I live outside of the limits of where military facilities are accessible so I am authorized to use civilian doctors to be seen as my primary care manager (PCM). Your PCM is the person that will give your the referal so that you can have the authorization to have lapband at no cost to you. I just had all of this done about 2 weeks ago. I have an appointment the first week of next month with a new doctor. I'm not starting over completely, but it has delayed the date of the actual surgery. The bright side to all of this is that I do not have to pay a co-pay and no out of pocket expense. If you choose to stick with the doctors you are currently with you will have to pay up to the cap and then 50% of whatever Tricare does not cover that is way that it is set up. That is you using your POM rights. So its up to you the way you wish to go, but I would definitely choose free over paying any day. feel free to write me back with any questions and I'll try to respond as best I can. I hope I've helped. - Dani