Lindalew

Hi everyone, I have been unsuccessfully trying to find someone at Tricare that could answer a few questions for me about qualifying for lap band surgery. I was wondering if anyone has had any luck with getting their surgery approved if you don't quite make the 100lbs overweight part. I am 5'5" and weigh around 223 but also take medication for high blood pressure, high cholesterol and insulin resistence. I've tried to look at weight charts but there are so many different ones out there I can't figure out if for my height I make the 100lb requirement. What a hoot...for once in my life I'm worried that I'm not fat enough. If anyone can help me with this is would be much appreciated. I've got an appt with the Dr's office Oct 13 but if there is no way Tricare will pay for the surgery I will probably put it off for awhile. Thanks! Linda

Thanks so much to all of you who took the time to answer my questions. I called Triwest again today and finally got someone who could answer a few questions. I am in the Kansas City area and I also called the weight loss clinic and asked them if I could get my $150.00 back if I didn't qualify for the surgery with Tricare. They said no problem, but I think I will still get that in writing before my appt. My husband is retired Air Force and is still working so Tricare is our secondary insurance. The woman I talked to today said I would first have to get the denial from BC/BS and then send in the claim to Tricare. HOLY COW, this sure does seem like a complicated process! The weight loss clinic said they will do all the paperwork for me so I guess it can't hurt. Now all I have to do is worry about gaining a few more pounds before my appt so I can make the 100lb requirements. That shouldn't be too hard!! Thanks again for all your help.

Hi RestlessMonkey, Thanks so much for answering me so fast. I just did my BMI and it is 37.1. The weight loss clinic that I have an appt with wants $150.00 for the initial appt. I just don't want to spend the money if there is a really good chance that I wouldn't qualify under Tricare. I am hoping that maybe someone else has been in my position and have had some luck. Thanks again. Linda

Hi Everyone, I just found this message board and all I can say is WOW! What a great source of information. I am seriously thinking about lap band surgery and am getting prices ranging from $17,500 to $13,500. (Kansas City area) The cheaper price of $13,500 doesn't include fills. They are telling me that there is approximately 4-6 fills the first year at $175.00 each which is not covered under the $13,500 price. The other places that range from $16,500 to $17,500 include the fills and they tell me that you could need 18-20 fills the first year. I would appreciate any input on this dilemma. I'm not sure that the cheaper one is the way to go if I have to pay for all those fill. My insurance won't cover anything for me. Thanks in advance for any help with this. Linda

WOW, What a great group you guys are!! Thanks so much for all the quick responses to my dilemma. Tracy in KS, I live in the Gardner area so I am looking around the south Kansas City area. I thought that the 18 to 20 filles a year seemed like alot. I think thats how they justify the highter price. Thanks Again everyone Linda