ArmyOfMe

Thank you, Cathy.

Hugs, Joy. I will say a prayer for you. I am hoping for a miracle for you.

Oh my goodness, Joy. I am so very sad for you. You made me tear up. :hugs I understand the physical and emotional struggles obesity has put you thru. I just don't understand insurances that deny people like us, a chance like RNY to a healthier happier life. I really don't know what is going to happen with me either. I am in God's hands, right now. Not even Dr Pen's intervention worked? It did not weigh in with the board?

You are in my prayers!

I will say a prayer for you. I sure hope Dr P can work his magic. Earlier in the day, I got a call from miss Margaret and I am in a bit of a pickle too. Tricare wants 2 months of Physician supervised diet. Five different Tricare Reps told me there is no such requirement anymore. Well, now I don't have that, because none of my PCM's ever offered me such an option. I would just get the regular diet and exercise speech. It starting to hit me hard, right now.

I think I am still not fully realizing I might have RNY soon. I have been obese all my life and just cannot picture myself healthy and fit looking. I don't feel nervous nor very stressed yet. Maybe once I get my answer, it will hit me like a pile of bricks and I'll be running around looking like a beheaded chicken. hahaha I'll definitely be saying a prayer for us all.

Does anybody here have any experiences with Doctors W. Scott Pennington and John G. Touliatos? TIA

If Tricare approves me (I think miss Margaret submitted my case already, not sure though), I would have my surgery by end of May. I am moving in less than two months, reason why the surgeon wants me on the OR table asap. I need some time for recovery and post-op appointments to make sure I am healing properly, before I leave AL.

I also wanted to add this info for you. Hope it helps. http://manuals.trica...a0+5a1+5a8+61c+

I am undergoing RNY surgery soon with Tricare (Standard plan). I was told by 5 Reps (I called them a lot with various questions) that there is no 6 month diet requirement, I can chose my Bariatric surgeon as long as he is in network and apporved by Tricare and I will have co-pays, of course. Everything else is at the surgeon's discretion and how they present the case. Also, coding has to be correct or the patient might risk enormous out of pocket costs. You can find a list of Tricare approved Biariatric surgeons on the Tricare website under Provider Search. Shop around, interview them and see which one is more experienced and give you the facts and also, which one you are most comfortable with. Good luck.

In my case, I don't know with Tricare. I am hoping/praying they won't make it difficult for me. Luckily, I have an awesome Bariatric Coordinator. I would think, if Tricare approves me, I'd have a surgery date soon after my pre-op diet.

Me too. :hi5

Thanks for your reply. Dr Pennington is my surgeon, as well and miss Margaret is my Bariatric C. They are truely amazing and caring. I loved Katelyn, the Fit lady and the Psych lady, too. That's about how much I paid last week, $300. I did everything in one day since I live near Montgomery and cannot drive to Birmingham at their convenience. I'm waiting to hear from my insurance (living on a prayer, right now), so we can move along with the pre-op diet and than schedule the surgery. That Endoscopy was no walk in the park. Now I know how it feels like to be abducted by aliens and probed thru the nose. hahaha Dr Pen was really awesome and careful about it and his nurses really thoughtful. Wasn't as painful as I imagined it to be. Who knows, maybe we will cross paths on the 6th floor.

Wow! That's not okay. IMO, it's not worth frequenting that particular "support group" if they are that divided. You go home more frustruated than feeling like you got support and undertsnding. Isn't it the whole point of a support group, kwim? The couple of friends you made there can keep in touch with you outside the group sessions. The fiendship is not completely lost. Personally, I am the kind of individual that walks out without looking back but not before giving people in the wrong a piece of my mind. I would more than likely find a support group that actually gives support and not the opposite.

Hi I am still in the process of approval. Surgeon said sometime May-June timeframe.

:hi I am in AL, as well. Montgomery area.

This is all good info to keep in mind. Thank you, ladies. I got my PCM to work on the Letter of Medical Necessity to be sent to the Bariatric surgeon. I am still waiting for her office to call me about the Orientation meeting (I think that's what it is called). Meanwhile, I had an EKG and lumbosacral spine x-ray done and I am expected in two weeks for lab work and Echocardiogram. My biggest problem is the fact that I will be moving in 4-5 months to the West region and I am scared the surgeon will reject me since I won't be here for the long term follow-ups with him. I would like to have the surgery where I am at right now because I have a strong family support here who can help me and care for me and my child. Is it possible to continue the aftercare with a new bariatric surgeon at the new location and have him send regular updates on my progress to the surgeon who did the surgery?

I don't want to start a duplicate thread about the same topic Ticare Standard Requirements but I would also appreciate some input from those who underwent GBS under the Standard Plan. Here is my confusion: 1st Tricare Rep said I do not need referrals nor a PCM to write anything. Just to go ahead and schedule an appointment with the Bariatric surgeon in network. No 6 month diet proof, no diet history. 2nd Tricare Rep said I do not need to show a 6 month diet proof but I do need a Letter of Medical Neccessity from my PCM sent to Tricare for pre-approval and Tricare sends me a list of their choice of Bariatric surgeon to colaborate with. 3rd Tricare Rep said I do not need a PCM, do not need any referrals, do not need diet proofs. Just to constact the Bariatric surgeon in my network. Also, Tricare does not have any documents, manuals, broshures specifically for Bariatric Surgery. If I call a 4th time and get another different answer about their requirements, I am going to strangle someone. Anybody had GBS with Tricare Standard Plan and can give me/us some real facts? Any details are appreciated!

I recently PCSed from Warner Robins (I miss it so much). I think you have more options in ATL since it's a huge city but def look into the PP's recommandations, too. Good luck!

I have Tricare Standard, as well. The Tricare Rep told me that my PCM has to send a letter of medical neccessity to Tricare and they will approve ot deny my request for GBS. She also mentioned that if my BMI is under 40, I am required to have at least one or two co-morbidities. For BMI of 40 and up, the chances of approval increase. The lady also mentioned that a 6 month diet is not required by Tricare but it's at the surgeon's discretion. I don't know if this applies to Standard only - this still confuses me. I have no idea about any co-pays other than the 15%-25%. ETA: Typos