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Everything posted by mswanson502
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When I went in for a consultation, I was told that Tricare no longer covers the gastric sleeve at all. I am SO upset. That's what I was going to have. They used to cover it. Why the change I wonder? I'm definitely not getting the Lap-Band. I know 4 people that have had it, and not one of them lost more than 20 pounds and then gained it back even with adjustments. So I'm left with the gastric bypass which has many more complications. But there's nothing else to do I guess. : (
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Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
The two main things were Polycystic Ovarian Syndrome and hyperinsulinemia. I also have high blood pressure, and pre-diabetic and have extremely high cholesterol. -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
Guess I gotta find a gastic bypass forum now, lol. -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
DonRondolfo, their prices are pretty cheap! The lady's that was $46,000 said she lived in Alaska, so I'm sure that's why. It's outrageous for anything there. I think mine will be around $23,000. After talking with the surgeon, we decided the bypass was the best way for me to go anyway. I have 5 comorbidities, two of which cause severe weight gain, so I absorb fat really easily. With the bypass, you don't absorb fat the same way. Yes, it's a lot more risky and has more complications, but I really don't have a choice. My PCP said I'd be dead within 2 years if I didn't do something. : ( -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
Good news! I was negative for h pylori bacteria! He knew as soon as he was done with the scope, but he didn't tell me since I was asleep. I guess he thought my MIL wouldn't remember to tell me that, lol. Anyway, now I just have to have my psych and cardiology appt, and I'm good to go. I'm already approved. -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
Well, I had my appointment Wednesday. He recommended I get the bypass due to my health and challenges. So that's what I'm going for after some thought. I had my scope done Friday to check for h pylori. I was asleep when he came in, but all my MIL was told was that I had a hernia, gastritis and an ulcer. I was sent home with a Rx for something. He didn't say if I had h pylori or not. I'm scared I may. I really don't want to put this surgery off another 2-3 months. I need to be completely healed by July. How long does it usually take to find out the results of the h pylori test? Any idea? -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
Oh ok. Yeah, that's def it. When I Googled prices in the US, it was around $25,000. But I have no idea if that included hospital costs. I'll find out hopefuly Tuesday. -
Wow- just informed Tricare not covering sleeve
mswanson502 replied to a topic in Insurance & Financing
I sure hope it works out for you. I can imagine how stressful it is waiting. : ( -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
OMG! $46,000 or more? That's horrible. If it's that much, I can't even afford the 20%. Eek! -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
Thankfully I have Tricare Standard and can go about anywhere. I have to pay 20% though. It will be worth it! I don't think I could self pay. It's gonna be hard just covering the 20%. -
Why has Tricare denied gastric sleeve?
mswanson502 replied to mswanson502's topic in Insurance & Financing
How much does it cost being self-pay? Unfortunately I cannot get new insurance. My husband is military, and I'm not working. : ( -
Wow- just informed Tricare not covering sleeve
mswanson502 replied to a topic in Insurance & Financing
I was told this also. I was not given another code to try because I hadn't started the process yet. I just figured I'd have to have the gastric bypass done instead. Anyone know why Tricare isn't covering it now?