samakar1516
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Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
NewMeLinda.......hi, sorry it took so long to reply. Have had a lot going on and not thinking about looking at the posts. Have you had any progress? I had my surgery June17th, after waiting and working on this for over a year! Let me know what's going on with you.....talk to you soon. -
Need-a-Sleeve reacted to a post in a topic: Survival On Pre-Op Diet
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Survival On Pre-Op Diet
samakar1516 replied to mjs6206's topic in PRE-Operation Weight Loss Surgery Q&A
In our program theywant you to go on a diet as soon as possible, and then 2 weeks before surgery you go on a liquid diet to shrink your liver, so that it's easier to get out of the way (for laproscopic surgery anyway). If your liver is too large then they have to make a big incision to do the surgery. I've been told that having it done laproscopically is better for you...post surgery wise. -
Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
Hello everyone.... Sorry I've been away for a while....I've been trying to work out this Tricare thing, and in the middle of it my husband came home (he's currently working overseas in Africa), so I've had my plate full. Well, good news! The clerk at the bariatric clinic in the MTF got me into the program...so I'm in ! I've already been to one support group, as well as orientation this past Friday. I will say that it all sounded a bit scary, but I'm sure it's not as bad as it sounds. If anyone else has had any progress please let me know! Take care.... -
Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
Thanks for the onfo. Char. I passed it along to the person in the bariatric clinic; got her voicemail so I left a message. But as I stated in my previous post, we just learned that Womack put a freeze on it, so it would be my guess that if the commander of the MTF put a freeze on it, it would trump all other efforts. But of course I'm not sure and that's why I passed it along...you never know. I assume that Bragg is low on surgeons and that's why the freeze. They deploy a lot of medical personnel from Bragg, which does effect retirees having things done on post. -
Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
This is where it can get a little tricky, and I think some of it depends on your MTF. This is what I was told by the medical management team at Tricare......these were suppose to be my 2 options: 1) If the clinic at the MTF says they have room for me then just make an appointment and go. 2) If they ask for a written referral, all you need to do is get your doctor to write something up to give to the MTF clinic. I told those 2 things to the bariatric clerk who approves the referrals, and after her doing some more research, that is when she found out that there was a freeze on us being able to use the MTF for the bariatric clinic. So that's why I'm saying that your MTF may have something to do with it, and you won't find out unless you're very persistent and ask why not. I'm just hoping they approve it because I really don't want to get the gastric bypass if I can help it. I don't want my insides rerouted and the malabsorbtion issues as well. Tricare needs to wake up and get with the times. The clerk told me that they've been doing the sleeve since 1998! I think it's almost to a point of discrimination against retirees. But what I don't understand is, I can't be seen at Womack for anything, but if I do happen to go there for whatever reason, all I see are active duty and really old people.....am I missing something? -
Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
Here's an update.... Found out that the MTF disapproved my referral. I called the clerk at the bariatric clinic at the MTF and she said that my name never came across in the system. I don't want to drag this out, but to make a long story short....she finally called me today and told me that unbeknowst to her there was a freeze on non active duty beneficiaries because of the lack of surgeons. She has made an appointment to speak with the Col. in charge of her section to see if they can get it lifted. She said there's myself and another woman that she's trying to get in there. So if the Col. agrees she has to write a formal letter to the commander of the MTF requesting that the freeze be lifted since supposedly they can do it. I told her that the only reason why I was pushing this is because I want the sleeve gastrectomy and not the bypass, and the MTF does it and Tricare doesn't cover it for civilian health care, and that's if the civilian doctor even does the procedure. So now it's in the hands of the powers to be at the MTF. Keep your fingers crossed and say a little prayer for me if you would....I'll need it! But what's going to drive me crazy is that the Army moves quickly for no one, and it could take a while before I hear anything...talk about gray hair!! All for now, Susan -
Whoever replied to this original post and said that Tricare does cover the slleeve gastrectomy according to the latest newsletter is incorrect. If you look on page 2 of that newsletter, it tells you what they do not cover, and it is listed on there as not being covered. But this should apply only if you're not active duty. If you are active duty, you should just be able to ask your regular clinic doctor for a referral or appointment to the bariatric clinic if your MTF does the procedure. Make sense?
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Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
I hear ya....... I should be finding out this week if the request that Tricare put into Womack (MTF) will be approved or not. I'm keeping my fingers crossed, but in case it's not, I guess I'll be calling the MTF to see if there's anything I can do to get into their program. I'll keep you posted.....keep the faith! -
Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 replied to samakar1516's topic in Insurance & Financing
I just received my approved referral in the mail yesterday for a civilian doctor. I called Tricare on Friday and they are putting in the request for Womack (MTF). WE shall see how it comes back. I will have the answer early next week, after the holiday of course. If I get no satisfaction from Tricare I will call the MTF myself and see what they say about it. Should be interesting....why does there always have to be so much drama! It's not like Tricare is paying for it themselves, especially when they don't even cover sleeve gastrectomies yet!! It really upsets me. -
Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 posted a topic in Insurance & Financing
I read in a post on this site recently that Tricare retiree beneficiaries did not have to go through Tricare to have the surgery done in an MTF. That is not necessarily true, at least in the North Region it's not. Womack at Ft. Bragg told me that we had to have a referral put in through Tricare. My doctor supposedly put the referral in requesting the MTF, but it came back approved for a civilian doctor, but of course Tricare does not cover the sleeve gastrectomy. I was also told by some at Tricare that all I had to do was to call Tricare back once it was approved and tell them that I want the MTF. Well, I tried doing that today and was told that they just can't change it, they have to put a request in to see if there was space available for me at the MTF. I told her to go ahead and do that then, so now I have to wait and see if it comes back as the MTF approving it or not....what a bunch of drama! If TRicare comes back telling me that Womack (MTF) disapproved it, I will be on the phone once again to Womack to see if there is a way I can get in there to have the procedure done. T His is ridiculous; it's like once you've retired you're put on the back burner and basically forgotten about....which is sad. If anyone's interested I ill keep you posted on what happens. Of course I probably won't hear anything till next week because of the holiday now.