irideaqh

I am finally approved!! :confused: It took about a week and I had to call Tricare several times. Since they wanted to change my surgeon due to the Center of Excellence thing, my actual lap band request from the surgeon's office was originally cancelled by Tricare since they had a hold on my PCM's referral until I authorized them to change it to the other surgeon. Then they were saying that I did not have a referral from my PCM even though on their computer system I could see that it had been approved. After explaining that to them, the rep said that my surgeon would have to resubmit the request for lap band. Called back later and got another rep and she said that she could send it through for review, the surgeon's office did not need to resubmit. I had to do that twice before it finally ended up going into review. The insurance person at my surgeon's office received a phone call from Tricare wanting to know if I had any comorbidities. She told them no, but that I fit into their 200% over ideal weight category. I guess they couldn't figure that out by themselves. Anyway I was approved that same day. So, I would suggest that if you don't hear back from Tricare, keep pestering them. Like my husband always says, the squeaky wheel gets the grease. Good luck to everyone else waiting for approval. Lisa in OK

Do they both pay for lap band surgeries? What are the requirements for getting approved for each? What about co-pays? You need to research them both and see which one better suits your wants/needs. Just because someone else has that same insurance company doesn't mean that their policy covers the same things yours would. Employers usually decide what coverage they want in the policies that are offered through them to their employees.

Sara, I sure hope Malibu does better. She sounds like she has improved since last time I had asked about her. It also sounds like she is trying to catch up to Kadin - wow she is huge! I started my lap band doctor research by going onto lapband.com which is the website for the band maker. If you register you can find a list of surgeons in your area. There were 7 in my area, but several of them were in the same practice, so there were only 3 practices in my area. There phone numbers and webistes, etc were listed so I went to each of their websites and looked around. It also lists the surgeons that have performed more than 75 lap band surgeries last year so you can tell which ones have more experience. The practice that I chose is recognized as a Center of Excellence by the American Society of Bariatric Surgery, so I think you could also check their website to see about surgeons in your area. I signed up for a seminar and really liked the surgeon and his staff. At that time my insurance did not cover the surgery, so I continued to research. I found a yahoo chat group for Oklahoma bandsters and read everything I could about the surgeon and asked people who used him what they thought and found out about their experiences with him. I also really like his program. I am not sure what all the other surgeons do, but he requires patients to attend a patient support group to talk w/ other patients and learn about their experiences before surgery. They meet monthly, but you only have to attend one, but you can keep going if you want. He also requires a pre op and post op meetings with a dietician who specializes in bariatric surgery patients. I think he provides the tools to help people decide if the surgery is right for them and also provides lots of support after the surgery to help patients succeed. Good luck with your search for a surgeon and w/ Malibu. Lisa

Sara, My kids are doing well. Thanks for asking. My filly w/ the OCD shoulder lesion has been on the Vitamins you recommended and I will be having her shoulder x-rayed again this spring. She hasn't been having any lameness issues. How is your filly doing? My husband is active duty Air Force so I have Tricare Prime insurance. They just started approving lap band recently so I am so glad I did not pay for it myself last year like I had considered. Tricare said I should know if I am approved next week. I have been overweight a long time and want to be able to get back into the show ring with some of my horses. Good luck to you and take care, Lisa in OK

Sara, I don't have any answers to your question, but wanted to say hi. Don't know if you remember me or not, but I have 2 FT fillies and am on the Equine Nutrition site w/ questions for you from time to time. I am still waiting for authorization from my insurance for surgery, but am on this site trying to learn all I can. Good luck to you and take care. Lisa in OK

Yes, my referral is for Dr. Keith at OWLO.

I am Tricare Prime, so I don't know if there are different requirements than for standard. The Tricare rep who called was very nice and had the name of the surgeon in my area that was affiliated with a "Center of Excellence" to refer me to. When I asked her how long it would take for me to know if my referral to see the surgeon was approved, she said she would take care of it right then. When I was finished talking to her I immediately checked my referral status online and it had changed from pending to approved. :biggrin: my2parrots - where are you located in Oklahoma? My husband is stationed at Tinker AFB and we live near Tecumseh. Lisa in OK