Susan Michelle

So far I've talked to my PCP, got a referral, called my insurance to see what they required, and am going to a seminar tomorrow. I am scheduled to meet with my surgeon on Sept 6th. However, when I called the surgeons office the insurance woman there was in disbelief that tricare doesn't require a 6 month weight monitoring. Now granted I'm sure they dont get a lot of tricare patients because I live nowhere near a base. but anyhow. When I spoke with Tricare on the phone (and looked it up on their website) I was told that I have to be 100 lbs over weight (check) with one or more comorbidites (I've got THREE) and have a phsyc eval... Anyone with Tricare have to have the 6 month weight monitoring? I've got medical history showing obesity for the past 10 years, but never six months back to back.

Thanks for the idea Dave! I'll have to slouch and measure myself to see if that would work... BMI I'm at a 39.5 so I'm SOO close to 40. ugh! THANKS!

Thank you soooo much! I have tricare prime and just started the process. I talked with my PCP yesterday during a physical and she told me to research surgeons and she would make the referral. I do have one question that you maybe able to help me with. Tricare says that I have to be atleast 100 lbs over the Met Life tables- well I'm currently at 258 & the table says I need to be 163-140ish. Does that mean that in order to be approved I would need to gain five pounds since I am not 100lbs over the top number? How crazy! I think it would almost be easier to gain the 5 lbs than to deal with the worry of not being approved! (I do have the required comorbities- never thought I'd be happy to have high blood pressure).

I have tricare prime and am considering lap band too. It looks very easy to get approved but my question is- they use the Met Life tables to determine if you are heavy enough to have the surgery. I'm currently at about 258 but my "zone" in the Met Life table says 163-140ish (i dont remember the lower number). I'm not 100 lbs over the 163. Will I have to gain weight to get it approved? Sounds ridiculous! Atleast its only five pounds.