mgordon1

Congratulations - good luck on your journey

One doctor I was going to used was charging an additional fee "$5,500" on top of my $3,000 insurance deductible. I actually got a referral to another doctor which does not charge a "fee". I have had my surgery and everything is going fine. I am glad that I changed to another physician.

I thought about doing my surgery in Mexico, however, I did not because of the follow-up and aftercare that are required with the band. In my area, I could not find a doctor that was willing to do the fills if they had not done the surgery. Also, my other concern was if there were problems with the band, who would I go to immediately. I posed this question to the doctors in my area and the answer was either no or it was going to be very expensive. This may not be true in everyones case, but this is what is available in my area. While it may be cheaper upfront, the after care and the maintenance made the decision for me. But like the others on this post, do your research and do what is best for you.

Thankfully, everything is fine since surgery. I did not have any pain, but I was sore. Even though I did have the pain medication from the doctor, gas strips and liquid vitamans, I only use the paid meds the night I came home. I know that everyone is different when it comes to pain, but I will admit that I am a big chicken:eek:. I have the Realize band by Johnson and Johnson and I can not feel it. The doctor showed me where my port was located and while it is not sore any more, it is tender. I have my first post-op visit on Friday. I will let you all know how it goes. And last but not least, I am thankful for Tricare. The only cost that I had out of pocket is my co-pays at the doctors office. Dallman/Don - congrats on your surgery, I guess we are band buddies.

I also made friends with the lead at Tricare West. She also told me that as long as you meet the criteria and had the surgery after Feb 07 they would reimburse you. I think it is a bit more paperwork, but you will get some of the money back.

Sorry I have not posted, but I have had my surgery. My weight was 268 and my co -morb was hypertension and cholosterol (sp) I had my surgery at a center of excellence facility.

Hi Rachel - I am currently out on leave from my job and depending on how close you are to your immediate supervisor, you do not have to disclose why you are out, just that you are having a medical procedure done and you will be out for xxx weeks. I only told a few of my co-workers that I was going to be out and again, I only told them that I was having a medical procedure done.

I have Tricare Prime and I went to a center of excellence hospital. From my perspective it is worth it to go to one of these facilities. It requires an overnite stay and they are more equipped to deal with issues related to weight loss. I was monitored very carefully and I don't think I would have recieved the same type of care if it was done on an outpatient basis. The hospital I was at El Camino in Mountain View California, had someone talk to me regarding aftercare, nutrion etc. They basically wanted to ensure that I had everything under control and provide me with f/u numbers for my care. The first night after surgery, believe me, going home was not an option for me. Between the antibiotics and the pain pump, I was glad I was there. Any questions, post pm me.

Yes they approved and my surgery is on Jan 30. I have Triwest. For Triwest, it took two days for approval

Hi Everyone - I am scheduled for my surgery on 1/30/08 and I have some questions. I want to know what is a should I have with me for the initial two weeks after surgery to make the time go easier. I am a complete chicken when it comes to pain, so I already have my prescription for pain medication. Also, I am wondering about liquid Vitams and Liquid Tylenol. Are these items available for over the counter purchase or by prescription only? Thanks

With my original doctor office, I was told "why do you want to fool with that (lapband) do the RNY and get it over with" Needless to say when it was all said and done, I switch doctors. With my new physican he quizzed me on both and asked which on I was more comformtable with. He only agreed to give me the lapband because of my information on both, how I planned to incorporated the new tool into my lifestyle and what I was comfortable with. For me, re-arranging my "internal plumbing" was not something that I was comfortable with

I am also pre-op and I was trying different chewable vitamins(flintstones etc) and I did not like the chalkey after taste. I ordered one bottle of Optisource Chewable Vitamin and Minteral Supplement from Walgreens.com - Online pharmacy & drugstore, prescriptions, health information, photo center and they taste very good, no after taste at all. I had my pre-op appointment with the hospital and doctor and they both agreed that is all the supplement that I needed. I have to take these vitamins 3x daily.

Hi - I ditto the previous comment. It depends on where you live and what kind of plan you have. I have Blue Cross PPO and my doctor and hospital are great.

Hi Everyone - I am scheduled for my surgery on 1/30/08 and I have some questions. I want to know what is a should I have with me for the initial two weeks after surgery to make the time go easier. I am a complete chicken when it comes to pain, so I already have my prescription for pain medication.

Hi - I was approved and have had my pre-op appointment with my surgeon and the hospital. My surgery date is 1/30/07. I am about 110 lbs over my ideal body weight - according to the chart and according to Tricare requirements, that alone was enough. My BMI is 43 and co-morb - blood pressure and chloresterol (sp). From what I found out Tricare South should have the changes on line by no later than 2/1/08.

Sgt Bob - I have Prime, however, the doctor that I chose is not a Prime doctor only standard. Another note, the hospital that I will be with is a Center of Excellence. I don't know if that made a difference. Good Luck

My surgery is scheduled for 1/30. My pre-op appt is 1/18. Ok, now I need some help on what to purchase or make sure that I have prior to surgery. Any suggestions would be appreciated

:biggrin:I got approved from Tricare for lapband. Will update when I get a date. Dallman - congratulations on your surgery date.

Hi Everbody - guess what I have, my approval/tracking number from Tricare. :-). They even approved my out of network doctor because the surgeons in my area (Northern Cali) most physicians know that Tricare did not cover the lapband and therefore the doctors did not take the insurance. I made sure that the service center was well aware of that. All I have to do know is get a surgery date from my doctors ( hopefully Feb or lates March) and the best part about this - not out of pocket expense other than my co-pay at my doctors office. 2008 is looking up.

Hi Everyone - recieved news from Triwest and as of 1/3/08 they have recieved the information that lapband is a covered benefit :-). The service center (reps on the phone) may not have the update as of yet, but the lead told me they have recieved the email from TMA to update their systems and it is now a covered benefit. She told me to have my doctor resubmit the information again (which I did on 1/4/08) and I will let you know what happens. The only problem that I may have is that my doctor is out of network which I have informed them of, however, living in northern california, they aren't many doctors who takes the tricare insurance, that are good and without maintence fees. I rescheduled my surgery until feb08 due to the insurance so that I won't have an high out of pocket expense. Thankfully, I have BCBS PPO as my primary @80% coverage and I want Tricare to cover the deductible.

Hi Everyone - I have been busy with family, holidays and on the phone with Tricare, it has been a journey. After talking to Tricare Management Office- TMA (headquarters in D.C. - that actually approved the change), the Triwest Regional Office (the office that overseas Triwest) and to the Triwest Beneficiary Office, they finally told me that the change should be updated in the manual by 1/15/08 or sooner. :whoo: I am crossing my fingers, toes, throwing up prayers and anything else that may help to get this through any sooner. Quick note, when I originally spoke with TMA (headquarters in D.C) they wondered how I recieved their phone number, I kindly told that google works wonders :-) Then when I expressed the urgency of the nature, my surgery is schedule for Jan 16 and I found a surgeon who is willing to take the insurance, then they tried to tell me about the RNY. I was a taken back considering this was not a medical professional and he had not reviewed my records, however, cooler heads needed to prevail because I wanted the information more than I wanted to tell him a thing or too. I informed him that my doctor and I decided that this is the best course of treatment for me and therefore this is the direction that I was going in. Then he decided to help:heh: I also got a denial, however, Triwest also has all of my records in their computer so TMA, Tricare Regional office and the Triwest Beneficiary Office knew that I was serious and was not going away. If anyone else has had any other luck with Tricare, please post HAPPY NEW YEAR EVERYONE - WE WILL ALL BE HEALTHIER IN 2008

The program fee that one doctor was charging was $5,500 for a five year plan. After I inquired what it was for - office visits, fills, nutrionist and labs regardless of your insurance status. When I told them that my insurance covers this , they could not explain it. Needless to say, I found another doctor that does not charge any maintenace fee and the same follow ups are done (fills etc.) I say shop around, but of course don't comprise on your health.

Ok - this one will be quick. My doctors office submitted the change to Tricare and low and behold, they did not have the update yet, imagine my surprise. So I basically walked them through the tricare manual website and showed them the online changes. Needless to say they were surprised and they told me, we did not know about this. They were wondering where did I get the information from. :-) Also, they have change 66 and 67 for the lapband. Change 67 deals with additional wording for the manual. Note to people using Tricare - print a copy for yourself and refer to it, it appears everything has not been updated yet.

:whoo:HAPPY DAYS ARE HEAR - THANKS FOR THIS UPDATE. :whoo: My lapband is scheduled for 1/16/08 and this is right on time. I phoned my doctors office and they are looking into submitting the paperwork again for me so I will not have an out of pocket deductible. I was not using Tricare because they were not covering it and I did not want to go self pay in case of complications. I was previously approved for the RNY so this should not be a problem. I will update the board with my outcome. :cry One question to anyone who has the answer, when I called triwest to confirm the change they were still saying the CPT code 43770 (Lapband) was not a covered benefit, however, when I told the rep about change 66, and the change to the tricare manual, she said that they would have to change it. Anyone else had problems confirming the information.

:help:Hi Everyone - has anyone used El Camino Hospital in Moutain View, CA for their lapband surgery? This is where I have to go and I wanted any feedback on your experience. Thanks