mynmann

Okay, I'm new to Tricare. Really new. My coverage doesn't even start until March 1st. I've already attended a seminar though... and the doctor their said he takes Tricare (though he didn't think Tricare payed anything for the surgury yet, silly guy). Anyways, I need to know how you do this. Can I call the surgeon direct. Do I need to see a physician first? Does Tricare assign me a physician or do I get to pick one? HELP! :biggrin:

I am so frustrated. I want the lapband but feel like maybe being fat me is just where I am stuck. I went Friday to my primary doctor and had very high blood pressure... the doctor put me on medicine and wrote me a referal for the Lap Band. My insurance only requires I be 100 pounds over weight and have something like high BP.... so everything looked great. I'd been talking with Dr. Bagnato's office and it looked like I might be able to use him (I'd hoped). I went to his seminar a month or two ago and liked him and you guys speak so well of him. Today I called and they said that their hospital doesn't take my insurance (Tricare) and neither did they. They'd love to see me but I have to come up with $17,000+. They were nice, but nice was all they could do for me. Me and my husband are both full time students and he works part time to pay our bills. He's also National Gaurd and will be leaving for war in the next year (SOMETIME??). We have 3 kids.... so coming up with $17,000 is beyond impossible. financing is impossible also, who'd give students with limited credit and no full time jobs $17,000? My insurance says they cover 75% and I'd just need to come up with the other 15%, which even that would be hard but not impossible. Anyways, I just can't find a doctor that will see me and take my insurance. I'd prefer one that doesn't require me to do 20 other things my insurance doesn't too (like phyc eval and nutrition) because my insurance doesn't require it they don't cover it either. More out of pocket. I called a random doctor from the list. I know NOTHING about him other than he's on the lap band site. Dr. Paul Macik. I hope he's great. His office says that he takes my insurance. I have to come up with $150 per visit... not to mention the $1800+ for the surgury before hand. He also will require me to see a therapist for the evaluation... which I'll have to pay for out of pocket. But he may allow me to bypass the other steps, sense my insurance situation. I hope this works out, but I'm just scrared it won't. I'm so tired of denyed and this is all more than my family can really afford anyways. Maybe it's just cheaper and better for everyone if I just stay as I am. Encouraging words would be nice or just advice.

My spouse is Army National Gaurd. We just got Tricare (the army health insurance) because we were told it covered Lap-Band. I went to my seminar today though and was told that they "cover" it but they pay "zero". I'm beyond stressed. I turn 29 this month and have been "obese" for the major part of the last 12 years. Yo-yoing up and down. My BMI is 38 so I was stressed enough about getting approved. Cause Tri-care says you have to be 100 pounds over and I'm 5'6 and 237 pounds.... I don't know if that's 100 over. It's 100 more than what I'd like to way but my healthy weight goes up to the 150's so that would mean I'd be in the 250, not the 230's. Weight gain has never been hard for me though and I can put on 15 pounds if I need to... I'm fighting to keep them off! But I must also have a health condition.... otherwise I must weight 350... which is goanna take longer! I do have on again off again hypertention. Usually it's just pre-hypertention... but I can stress myself and eat real bad and maybe shoot it up high enough to get approved.... though I could have a stroke too! I also have arthritis... but in my shoulder and they say it must be a "weight bearing joint" and at the time I don't walk on my hands... though if it means they pay the $17,400.00 for surgury and not me.... I could. I just have 3 kids and a spouse about to go to war. I want to stop this weight war and get control and get healthy. It just seems like the insurance company is out to kill me before they'll aprove me. I simply can't afford to finance this, it would break my family financially. That would be selfish of me. We only have one car and never get to go on vacations anywhere because we live so payday to payday.... now I'd have to ask my family to give up any and all fun we have money for (for several years) so I can get healthy and thinner. I just can't. Then today they say that they don't think Tricare will even cover it... ugh! Long story short, does anyone here have or know about Tricare. Do they pay zero on something they cover? Seriously? And do you know if I sound like I stand a chance of getting approved even if they do cover it?

Hey. I still read all your entries. I like your bumble bee thing on your arm... hehe! I just wanted to comment on how good you look. It's hard to tell what someone really looks like in the little pictures. Your really pretty. I'm also impressed in the difference that 17 pounds made. You aren't bulging in spots that you used to... like your tummy and your back at the waist area. You seem to be really defining into this curvasious shape. You also don't appear to have lost your chest... which is nice. I fear I'll lose mine. I want to do what your doing... keep my chest and gain a waist line and a flat tummy. That would rock.

I am so ill. I can't seem to get anyone who knows anything in my area. went to seminars and got my referall and all I can get is a bunch of Dr.s who either don't take Tricare or their hospital doesn't. I now have an appointment on April 1st but not with a doctor I know. I just can't seem to catch a break on this. I so wish I were wealthy or had super credit... cause I'd just self pay and be done with this. Sadly, as a full time student with a part time income.... I don't have the money nor is ANYONE going to give me the money.... so I'm at Tricare and Georgia Doctors will. UGH!

Hoorah! That's great news! My husband couldn't tell me if I snore or not.... cause he's to busy doing it! :biggrin:

Wow, they look good. It looks like they won't even be noticeable in any time.

How does it feel, post fill. Do you get full alot quicker. This is why I love your blog... cause it keeps me so informed on what it will be like. I am very interested in how much this will change my appetite. I would love to see your scars again, if you feel up to it. No pushing cause I know that's private. I'm just worried about how bad my scaring will be cause I scar easy.

Stupid question: How do I make my weight loss ticker work? I'm trying but I think it's not showing up right. Also, is my picture working... I can't see it.

Thank you all for your words of advice. I will stay on here asking questions as they arise, because your all so helpful and knowledgable. I am really set on Dr. Bagnato... if he can find a way to take my insurance than I'm his. Their is no way I could do self pay. I have two young kids and me and my hubby are both full time students. Our only income is my husbands National Gaurd pay and his part time sales job.... not enough to save up $20K. Without full time jobs I'm sure financing isn't an option either. Oh well, just pray for me. My appointment with my general doctor is on the 14th... even if I don't need it I figure I'll go ahead and get a referal, can't hurt. Thank you for everything.

I worry about what your talking about. I've yet to get banded but food is my addiction. I am unsure what I'll do with myself. I'd like to become an gym junkie.... just work out all the time for fun. What's the chances? I'm writing to ask about Dr. Bagnato. If I can work out this insurance stuff (Tricare) then I intend to use him. Does he have a good bedside manner. I'm easily intimidated and have trouble being open and talking to doctors if they come off real aggressive or unapproachable. I want a doctor I can feel real comfortable talking to, incase I have problems. If Bagnato can't then I am trying for Bernett... does anyone know anything about him. He seemed a bit more approachable at the seminar... I just liked the number of bands Bagnato has done and Bagnato seemed to have a real open policy. My weight is barely over my insurance requirements. I'm close to 250 and it should be 147.... so I'm right at 100 over. My insurance only requires 100 pounds over and a health related issue. I have asthma and arthritis in my shoulder... but don't think those count. I have high BP... normally 130something over 98ish. The top number is fine, but the bottom is high I think. It goes over 100 on the bottom and did often when I was pregnant. I had to be hospitalized for it during pregnancy and they induced my son a month early. Now 2 years later it's still high. I worry about that cause I don't want to have a stroke if I get really stressed out. I'm only 29 and strokes and getting breathed with ANY physical activity (even walking) shouldn't be worries I have. I'm hoping that Dr. Bagnato (if he will take my insurance) will work with me to help me get approved. I really feel I need this or I won't live to see 50. Please help, I just need advice from a pro.

I am looking for a doctor in Georgia. I want a good doctor (and I'm not even sure how to research them to know if they're as good as they say) and I'm also looking for an EASY doctor. I am on Tricare Reserve Select. They are so easy. No history, no therapy! All you have to be is 100 pounds overweight (according to Met Life table) and have 1 of their listed comorbidity things. I have both those criteria.... so I'm good. Tricare said I can go straight to the Surgeon to get it preapproved. Problem is all the doctors I call want me to get my PCM to refer me and have all these health problems and blah blah blah. Then I have to see a therapist and a nutrition person. It's just alot of work. Any suggestions on good Georgia doctors?

I am in Warner Robins, smack in the middle. Their are no Doc's in this area that do it.... so I'll have to travel. As long as it's in GA. I'm good. I went to Dr. Bernett/Bagnato's seminar and I liked them both. The only delay AT ALL I have with them is that Dr. Bagnato's staff said he doesn't take Tricare period and Dr. Bernett's staff said they do take Tricare but have yet to get one approved. All the friends I've made here on Tricare had theirs no problem.... so the delay Bernetts having is worring me. I told Dr. Bagnato's office that my Tricare "Tricare Reserve Select" allows for "out of network benefits" and doesn't require any referalls but I don't think she'd heard of it.... so she's calling me back. Wish me luck.

Okay. I've been on the phone all day. Is their anyone on this site that has Tricare Reserve Select that's been through the motions of getting approved or having the lapband surgury. It's a bit different than Prime or Standard and I'm getting SUCH a run around from doctors. They keep telling me that they don't take Tricare... but Tricare Reserve Select pays doctors "out of network" so I don't understand the problem their. They also want me to get a referal... but Tricare says I don't need that either with Reserve Select. Then they're saying all this history I'll need and that I'll have to see a therapist and nutritionalist.... but my Tricare doesn't require that either. How do I find a doctor in Georgia who knows about Tricare Reserve Select and won't make me jump through 12,000 unnecessary hoops? I really could use some advice.

Cool, well I think my ducks are good. My weight is right at 100 pounds over for my height and medium frame... though I am a bit taller than I have been saying. Not much, but when I measured myself yesterday I appear to be 1/2 inch taller than I though. Do they measure your height... or just take your word for it? My blood pressure has been staying high for a while, and I also have adult onset Asthma... I've kept record of my BP and record of all my doctors I've seen for it and for asthma. Should I take a record of my weight and all diets I've attempted in the last 12 years? Yes, also.... if you have that paper in pdf I'd love to have it.

YEA! I am so happy for you! :biggrin: My first appt. is on the 14th... with my PCM. Is he the one that takes your weight that matters, or is it the surgeon? Just not sure who submits what to Tricare? Is their anything I should prepare or take with me for the PCM or anything I should write for the PCM to send to Tricare?

Well, I am so happy for you. Everyone here who's changing it. My hubby is just the same, nothing but kind words to my face. But he also thinks Haley Berry is beautiful. How can someone that likes that shaped girl.... well how can he look at me and see the perfection he claims? As much as my heart would love to believe it.... well I'm far to logical and I guess skeptical. I'm just like you, hiding. Like if he doesn't see how fat I am naked then he won't know.... cause my clothes make me appear 100 pounds lighter.... LOL! :biggrin: I'm so weird but can't control it. I have big friends that are so confortable with themselves. They wear plus size lingerie and strute their Lane Bryant clothing... they dress to the nine's (with the nails, hair, jewelry and fancy shoes) and they feel great about themselves. To those folks I recommend no change, unless they are at some risk with their health. But for folks like me, people who will never accept themselves as is and can't seem to change it on their own then I think this surgury may be the next best thing to heaven. I actually have a kind of emotional attachment for the piece of plastic they are going to put in me... my Lap-Band! :tt2: I want to name it! :frown: I even get defensive when people attack the idea of it. How crazy is it, that I'm this excited?

That's just what I wanted to hear. I thought that way... that I'd feel just like that. I love how you said "second chance at life". I want that, that feeling right their. I HATE feelings how I do about myself. I NEVER let my husband see me naked (sorry if that TMI). I have so much shame and I rarely bother to put on makeup or do my hair... what's the point. I know that's horrible to say. But it is how I feel. I never go out looking unclean or anything... but.... what's the point in putting hours into my appearance.... no one notices me. I used to be bulimic. I've been thin in my life. My teen years, I was hot. But since the birth of my daughter I've been nothing but heavy. Now I've had my son.... I'm just gone. I'm still inside this massive amount of flesh and fat... but no one sees me, not really. Guys don't notice me when I walk by, not if I spend 10 minutes or 10 hours on my looks. Not that I want guys... I love my spouse. It just would be nice not to feel like I don't exist sometimes. UGHH! I just can't wait for this surgury. I'll do whatever it takes to get it and I will be so good. I just need that little bit of help. To protect me from myself, and falling back into depending on food for everything. Pray for me! :biggrin: Thank you for being so inspiring.

That's great. You sound so good. I'm so envious. Just can't wait for my turn. I have a silly question. Do you feel "different"? I know you are... but do you feel it? I wonder if the moment after surgury if I'll feel like their is something real different about me.... like I'm sorta a new me. I feel that in my head, like that's how I feel. I just wonder if that's all just imaginary or if you do sorta feel that way?

I am sort of going through the same thing. Except I haven't seen a primary doctor yet. My insurance starts Friday as well and I've been wondering what to do. I'm a bit nervous they'll claim it as a "preexisting condition" if I file to quick. Which is silly, cause it would have to be. They want you to have been overweight for 5 years or more... so I'd of had to have been with the same insurance company since I was a teen for it not to be pre-existing. Anyways, I'm not sure but if I find out I will contact you. Myn

Hehe! She's a walking Tricare Manual AND a sniper. I must remember to keep you on my good side. I'm a tree hugging "LOVE PEACE and HAPPINESS" type. You may think I'm silly but I'm not a big gun fan. My husband carries a gun for a living... so he's often shamed by my "doe eyed idealism". Oh well - I am who I am. I'm a wuse. I cried once cause I killed a bug. :biggrin: But, congrats to you. That's awesome and I'm very happy for you. Better that good people like you have guns... espically when all the bad guys out their do. I'd just end up shooting myself on accident anyways.... I'm a major clutz. Have you lost any weight yet? How are your scars. My doctor (that I'm hoping to see) does the port different. He puts the port on the left side of your chest. Above the breast. He likes it better cause he says "in heavy people" the ports can be hard to locate.... and with your middle bending and twisting it can shift. He said that alot of times they have to X-ray to fill the ports. In the chest he said they can push to feel it and can fill it easier. Because of it he gives 6 free fills a year - no charge to myself or my insurance. It sounds need to me.... and you can't see it. Though I do wonder what it will feel like when you push on the skin??

How do I go about picking my PCM... do I call Tricare? Also, does anyone know where I can find a list of Tricare "accepted" doctors. I have a surgeon in mind but don't want to bother getting my hopes up if he's not on the list of approved doctors. Hey, Minpinmom.... how are you feelings. You're in my thoughts and prayers! Myn

From what I can tell, Yes that is so. Though I STRONGLY DO NOT recommend Bypass to anyone EVER. My BF and I are only close because that surgury..so I guess I owe it alot.... but it's bad bussiness. My friend had a Gastric Bypass, she had to have it redone (I believe 3 times) due to infection and ulcers. Then it got so infected it swole her stomach shut. She lost so much weight so quick that she got lose skin. Then she almost went blind and was being pushed in a wheelchair. We took her to a great hospital in Atlanta. They had to put her on a feeding bag. For 6 months she lived with my family. We had to pay her bills to keep her afloat cause she couldn't work at all. She couldn't eat anything, for like 6 months. All her food was fed through a bag that they put a stint into her arm that ran into her chest area. It was horrid. After multiple procedures she got her stomach healed enough to come off the bag. Now she's on her own again and is very thin and beautiful. She is CONSTANTLY sick though. She throws up all the time. Has horrid stomach pain. Also her Iron is VERY low due to the "malabsorbic" thing. I worry that she won't live long the way she's going. From my perspective, the Bypass is just as risky as being grossly obese. The Lap-Band is so much less risky and in the long run just as effective. Those I know with the Bypass eventuallly start to put weight back on. With the Band you can forever control that. Just my opinion.

I adore you. You are like the "Lap Band Hero". Just so clever. I've been eating everything in sight. Still worrying I might be 1 pound under.... now I'll just shove tiny little weights from my ankle weight set (they're like thin round cylinders so I can hide them in my shoes and DD bra size)... and I'm sure I'll have it. THANK YOU! I'm going to start a new thread when I return this afternoon and I'd love for Min Pin Mom to look at it if she can.