srhall13

Hello everyone, I have Tricare Prime North Region. My BMI is 45 and I am 200% over my ideal body weight for my frame. I have no comorbidities, but everyone over the age of thirty in my family has high blood pressure and diabetes and is morbidly obese. I am 25 and realize that it is just a matter of time before these health problems touch me as well. I live in North Carolina and am being seen by Dr. Johnson at Carolina Surgical Associates in Morehead City, NC. I thought being 200% over my ideal body weight was enough, but my doctors office said that I need to be at least 100lbs overweight for the last 3 years for tricare to approve the surgery. I have only been 100lbs overweight for two years. I have not heard anyone else talk about this requirement and a time limit is not mentioned on the tricare website. Has anyone else run into this time limit problem with tricare? Thanks

Thank you all for your responses!! I talked to a tricare representative this morning and they confirmed to me that there is no required amount of time to be overweight. It is just a matter of necessity. My PCM has written me a letter of medical necessity, so that is not a problem. I have stayed in close contact with my surgeon's nurse, so I am going to call her this afternoon to ask if this is thier policy. I love my surgeon and his staff is great, but if this is his policy than I may try to find another surgeon in the area. It is just frustrating because I am doing everything that they require quickly, but seem to be hitting speed bump after speed bump. Just trying to keep a good attitude!!!