Keleka

I'm seeing Dr. Glembot!:thumbup:

Hi Gilliebean! I haven't yet but hope to soon. I see the surgeon tomorrow! Can't wait. I haven't seen anyone post from around VA/WV area. Good to see you!!

Woo-Hoo! This is GREAT! My name is Teresa - no kids - just 4 cats! LOL - My husband is Air Force ANG Active Duty 33 years! Getting closer to retirement hopefully within the next year or two! I'm in WV about an hour and a half from DC! Good to meet everyone!

I have to pay $750 program fee.. but at least it's through the hospital. They tell me it will cover 1 month Vitamins, lifetime access to a patient portal, patient manual, exercise specialist, monthly support group meetings and a variety of pre and post op services (not sure what the latter is for yet). I think it's a little expensive, but a price I'm willing to pay since I chose them and knew this up front. I also have to pay for my psych eval which is an additional $220. Not sure what the nutritionist is going to charge. Good luck and I feel you should be grandfathered in as well.

Hi.. I'm TriCare Prime Remote North. I was "pended" for my Psych consult. It was pended for about a week until I called and checked on it. They had someone call me 2 days later about it. The psych that my surgeon wants me to see wasn't in network but it was pended for TriCare Standard, which basically means $300 deduct and 50% of cost. Translation....I pay out of pocket for psych consult. It's $220 which I guess is average. I would call and talk with someone at TriCare. They have been very helpful for me~ Hope this helps...

Hi LVICENT, Welcome! I haven't actually seen the Dr. Still in the beginning stages. However, I did chose Dr Glembot. Hopefully things will start moving a little quicker now!

I'm going to Dr. Glembot in Winchester Va... well actually that's the office...lol I haven't actually got to go to him yet~ yeah I have a lot to lose also. But I'm trying to realistic in my goal setting right now! My first goal is to hit onederland first then go from there. When they call me next week to do the phone part of my H&P she said this is when they will schedule my psych consult and any other lab work that is needed! She said they will also schedule me to see Dr. Glembot at that time! I can't wait either!

Hello, this is a wonderful site. I am considering the Lap Band. I just had my PCP office do a referral for me. I have Tricare and not sure who they are going to send me to. I have been browsing through this site for some time now and just registered! Thanks for all the valuable information here. I hope I do get approved! I know this is going to take a while since I am just in the beginning stages. If anyone has Tricare I would be interested to see how hard approval was.

Hi Dt and welcome! Was this your surgical consult visit? I'm not that far yet. I did go to the information seminar and also filled out my H&P online. I'm scheduled for the phone interview part of the H&P next week. It is slow going but I know each day it's closer. Good Luck!

Hi All! I'm TriCare Prime Remote North. I'm in the beginng stages but so far have been approved for the initial consultation. I have my phone H & P interview in 2 weeks. This is when they will schedule my psych consult and order any lab work. I am hoping all goes smoothly. I didn't realize TriCare reqiures an overnight stay. Did they tell your physician this when they obtained authorization? It's great to connect with other TriCare folks! Any info is greatly appreciated! Thanks!!!

Hey SkatKat! Finally someone from Eastern Panhandle! Did you have yours done in Winchester? I just went to the information meeting this past week. Now it's a hurry up and wait to see what my insurance will cover. I would like to know from the time you first went to information meeting to getting banded took? I have lots of questions! LOL Thanks for any info. btw... I'm in Martinsburg too!

Hi! I have TriCare Prime Remote and I just went to the information seminar this evening. They did height and weight measurements and made copies of my drivers license and insurance card. They said they will call Tricare and find out exactly what I will be responsible for and let me know in about a week. I don't have an in network physician near me that participates with bariatric surgery so I am hoping Tricare will cover this physician at an in network cost.

WOW! Jenn that's great! I would be bouncing off the walls too! I was wondering if your Dr was in or out of network? Just curious! Thanks! I'm in the beginning stage of the process.

I'm really sorry to hear this about your surgery~ Hopefully things will work out for the best! I too am concerned about the whole TriCare thing! I have TPR and have a referral to see the Surgeon for evaluation. The problem is he isn't in network but accepts Tricare. Now as TPR this could mean a couple of things: 1 - I will be responsible for $300 deductible and 50% of costs. 2- Maybe since there isn't an in-network provider TriCare will cover it at 100% The one good thing is when I go to his informational seminar (I have to go this first before scheduling an apt) They make copies of insurance cards and call the insurance company to see what exactly is covered. So I should know up front what I will be responsible for. Any other TriCare information anyone has would be great!:scared2:

I will keep you posted! Now I just have to wait for the information seminar! Thanks!

Thanks Stay Tuned! I did email TriCare just now to see what else the may require in the form of paperwork. You have given us all Hope!!! Thanks Again!

I have TriCare Prime Remote - I got approval to see my surgeon for evaluation but I need to go to the information seminar first! I have already signed up and its scheduled for June 5th. I hope it won't take long to get an appointment after that with my surgeon. Side note, my initial referral has not shown up on Tricare website - but I called and got the approval #. Not sure why it isn't there.

Thanks Gina:smile2:! Not know what to expect is half the battle! That's why this site is great! We can all share our experiences! Sounds like once the ball gets rolling it won't be too bad. Keep posting on your progress and Good Luck!!!!

Hi Gina! Thanks for the post. I have a question.. are you TriCare Prime Remote? And was your Doctor in-network? The one I am going to isn't in network... but then there isn't another surgeon in my area so I am hoping mine is covered at 100% I was approved though for one visit.

Hi All! So I called TriCare this morning and was told I was approved for the first visit to the surgeon!! YEAH! I called the surgeons office to make the apt and she said that before they can schedule an apt I would need to go to the informational meeting. I told her I was already scheduled for that and I told her I already had my referral # for the first visit. She laughed and said I was ahead of the game! I hope things continue to go well! Will keep posting updates!:tongue:

Hi aculberg & katinafer! I'm still waiting to get the referral to go to a surgeon. It says on the tricare site to wait about 72 hours before checking, but I don't think they post very quick on their referral and auth page! The funny thing is the Dr they originally had me going to was a vascual surgeon:huh2: When I got home this evening there was a message for me to call their office (they probably want to know why tricare is sending someone there for lap banding:confused2:)lol So anywho, I am really hoping the Surgeon I would like to go get authorized! Once I am able to go I don't think I will have any prob meeting the requirements (5'3" approx 275 and high blood pressure) I know with TriCare you really have to keep on top of things! And not give up! I'm TPR north region and I'm not sure as to what the else they require as far as nut, psych etc consult. So any info you get please pass on as I will also! It's nice to know and meet others going through this! Let's keep each other informed!:biggrin2: Thanks and good luck to both of you!!!!

Ok... so I've been waiting since last Monday to see what surgeon TriCare is going to send me to. It turns out after I called my PCP they (TriCare) faxed them a general surgeon whose specialty is vascular! So I called TriCare and she told me if I could find a Surgeon who accepts TriCare that does lap banding to have my PCP fax the info to them. It turns out the surgeon that did my sisters Gastric Bypass is now doing banding. I already have my appointment to go the informational session. I just hope TriCare covers this at 100% I feel this may be a long road of making sure every T is crossed and I dotted! I would be interested to see others trials in getting approvals!

I know what you mean about doing something soon! I wish this would have been available years ago! I will keep posts on what i find out. BTW the only other comorbidity I have is blood pressure but only take a mild water pill for this. Keep posting on your progress as well!

I thought Tricare just required one comorbidity with being 100 pounds over weight or no comorbities if you were 200% over body weight. I just called my PCP last Tuesday and I thought they were just going to go ahead and fax TriCare for a referral for a surgeon for me. I think I would qualify under either requirement. I keep looking at the referral authorizations section on TriCare website but nothing yet:confused: I guess since I made the decision to do this I'm just a little inpatient for something I know is going to take a while. I have TriCare Prime Remote so I'm not even sure what surgeon they will send me to! Good luck with everything!

Woo-Hoo! Congrats on the approval!!!! I can't wait either!!! I'm just at the starting gate waiting on a referral for a surgeon from TriCare! Good luck with everything!