My wife recently received a denial from TRICARE for gastric bypass. The reason being is that she had lap band surgery some 8 years ago and it was not successful. The lap band did not set right on her stomach and the doctor recommended it be removed and that gastric bypass surgery be performed at the same time. TRICARE denied the authorization for gastric bypass because she had the lap band surgery. I realize that TRICARE only authorizes one weight loss surgery in a lifetime, but the kicker is that we did not go through TRICARE for the surgery and we paid totally out of pocket.
Anyone have any thoughts on how we can appeal this denial?
