talking

Choromom, Good reply. You are correct. In my case (TFL), since Tricare is secondary to Medicare, it covers only the remainder that Medicare doesn't (80%/20%). Banders that have had their banding covered fully by other Tricare plans (Prime, PLus, etc.) probably have Tricare as their only coverage. Thanks for the reminder.

kristina, This contradicts everything I was told by Tricare, both in their local office(s), and during 4 or 5 phone calls to Tricare, and to TriWest, the managers for Tricare-for-Life. Understand your spouse is active duty, and you are Tricare Prime? How are you swinging it?

I have Medicare part B and Tricare-For-Life, and have decided to have the Band procedure. I'll probably get banded the last week of June. I plan to get the Realize brand rather than the LapBand brand. Basically the same device, but it has a much lower profile fill-port. I'm in the process of planning for surgery at either Banner Good Samaritan, or Bridges Weight Loss Center at St Lukes, in Phoenix, AZ, and have attended seminars at both facilities. Those two are the only Centers of Excellence in AZ that have Bariatric surgeons contracted with Medicare & Tricare. DRs Hilario Juarez and Daniel Fang, both experienced, respected Bariatric surgeons, practice at both facilities. I'm told that Dr Robin Blackstone, the sole Bariatric surgeon at Scottsdale Bariatric Center, the only other AZ Center of Excellence, has just recently ended her association with Medicare, so if you have Medicare, Juarez & Fang are the only two choices in AZ. For no particular reason, I'll probably go with Dr Fang. Medicare, Tricare, the hospital, and both surgeons all assure me that Medicare will pay 80% of the cost, and Tricare the remaining 20%. Excluded from their coverage are the surgeon's requirements (not Medicare, Tricare, or the hospital's requirements) for a Cardio eval, a Psych eval, and a Pulminary eval (required because I have sleep apnea). Also an optional $140 Nutrition consult. The AFB hospital does not have those specialties on staff, so I got consults from my PCP & Tricare, and paid a $12 co-pay for each of those 3 outside visits. There are some labs required, and if any are not covered by either program, I'll get them done at the hospital on base. Unless there are some really hidden costs that I haven't discovered yet, I expect the procedure to cost me a total of $36.00. It's my understanding that Tricare doesn't pay for banding except as secondary to Medicare, so having Medicare part B and thus Tricare-for-Life are a given, and then everything should be covered, but I could be mistaken. If anyone out there has Medicare & TFL coverage, and has had the band procedure, please tell us about your experience, specifically your final out-of-pocket costs. Thanks. WOW! Long first post! :biggrin: