dallman

If you look up the cost share it is 25% of the doctors fees and up to 545.00 of the hospital fees. You can find that sheet on line. I have met the deductable allready. This is just what you are required to pay. Here is the web site. I am retired and have standard. TRICARE Cost Share Don

I have tricare standard and had my band done on jan 28th. I have lost 38 lbs so far. I have only had two fills which have not done any good but will get another one soon. I have tricare standard. I was approved the 14th of jan. I have so far only had to pay my doctors fee which was 245.00. I expect to pay 545.00 for the hospital and maybe a small percentage for fills. It took me two years of trying to get approved and then once the change came in less than two weeks as soon as I could get them to read the change. In fact I sent them a copy. I work out 5 days a week and is the main reason for my weight loss until I get some restriction. Don

I have blue cross and tricare standard. My blue cross has a wls exclusion. They had to get blue cross to disaprove the surgery and then filed the tricare will let you know what the cost was when i get the bills. Send me a email so i will remember. I used Dr Morton at Baptist Hospital in Nashville Tn. I do not think it will cost much more than 2000.00 hopefully less. This doctor and hospital is not in the tricare network but is one of the centers of excellance. This doctor has done more than 1300 lapbands and experience drove me to him. Mini I am reading a lot but not posting much I am happy that you got approved. I have my first fill on the 18th of Feb and can't wait. I have reverted to a atkins style of eating to keep from being so hungry. But is all good I am back to swimming 1/2 mile everyday and lifting weights everyother day. Don

I had my surgery the 28th of Jan. and have lost 10 lbs so far. My starting weight was 343 and height is 5' 11". I have high blood pressure and sleep apnea. I started walking a mile the day after surgery and have increased that to walking longer and lifting light weights every other day. Don

Change 66 issued today. Manual Finally, Don

Good Luck to everyone. The Two week diet is a killer. Don

I have my surgery date. January 28th. This is so easy after finally getting tricare to approve it. The paper work they sent in on me was compiled in Feb 2006. Nothing else needed. See you on the other side (band). Don

Talked to my nurse this morning Tricare requires nothing else from me. What ever they sent in orginally is all they needed. I know the letter from my Doctor was a over a year old. If you want a laugh they called the nurse this morning to see if I had the surgery yet. I will have mine the end of the month or the first week of Feb. I am required to do the 2 week diet before surgery. Will update you later as I know more. I tested to see if I'm sane enough for the surgery tomorrow and stress tested next Wed. None of which is required for Tricare. Don

I am still tring to find out. It says I am approved so the nurse thinks all I need is a psyc eval but that is for my doctor not Tricare. I have that appointment set up for Thursday and will try to get more info then if I don't get it before then. She is supposed to call me later on today. I will let you know when I have more information. Don

I have in my possesion a letter of approval for my banding from the tricare appeal board. After over two years of waiting I am on my way. Thanks to everyone for any help that you have given me. :rofl: Don

Called Kentucky to the appeal board this morning to let them know that the no pay codes have changed. I asked them when should I recieve my approval letter and if there was anything else I needed to do. Will let you know when I get a reply. If any one gets approved let me know. Also if you get a list of requirements from them pls let me know. This must be a list from tricare not a doctors list. Thanks, Don

We are no longer on the no pay code list as not approved. Hope to see the change in the manual shortley. There is a new list out today dated as of Jan 1, 2008. One more step down a few more to go. Don

I have contacted humana and talked to their rep and of course they did not know this had been approved. I was told to appeal their denial so my case would be put in file to be pulled as soon as the change is implemented. From what I can gather Humana is the contracting officer for this area. I have sent the appeal and will wait rather impatently for my band. Don:cry

Got my disapproval back from humana. I expected that. I am trying to call and see when they expect to have the change installed. Hope to have it done in the first 3 months of 2008. If anyone has any better wibsites than I have posted before pls let me know. Have a Merry Christmas. Don

I talked to my nurse today and she has sent for pre-approval and thinks all of I need is a doctors letter and a psyc eval. I know for gastric bypass tricare is very easy to get. The 200 percent is if you weigh twice what the insurance standard says you should weigh for your height. I expect to hear something back next week or at least right after the first of the year. Don

The first message ran out of room. I sent all of the new information to baptist hospital here in Nashville and am waiting for them to get back to me concerning what I have to do to get the band. I had a loan approved for 16000.00 and backed out in july determined to wait as long as possible to get Tricare to pay. I would have only waited one more year and then would have paid for it myself. Don

I use two sites for updates the first is the one for manual updates the second is the site for no pay codes. Manual TRICARE: No Government Pay Procedure Code List The second still has not been updated but should be in the next few months. This third site is the manual but again it has not been updated yet and I am sure it will take a while. TRICARE Beneficiaries : Covered Services -

I am faxing in the new change to my doctor tonight and will let you know what happens. I would imagine it will take a couple of months for everything to get loaded and it show up everywhere. Sorry for your loss. Don

Change 66 issued today covers lapband. It is effective until Feb 1, 2007. I believe you should read it for your selves. Manual Don:)

The newest manual change is out for tricare change 63. Lapband is still excluded:mad:. Don't know what to say. I thought it might change but I don't see it in the near future. If they were going to change the policy you would think we would have seen it in this change. Don

That is what is being said but no change has been made in the manual as of yet. I have sent e-mails to tricare with no response as of yet. I suspect it will be January before it goes in as a change in the manual and the xl sheet that shows what is authorized. Don

Thank you so much. I hate to wait but should be good at. It has been over two years since I made this decision to get the lap band. I have even had the loan approved once but backed out last month. I just knew sometime or other they had to approve the band if the VA and medicare was approving it. Don:)

Sounds good. Are you using a civilan doctor? I just want to make sure this is not being done on a base because many are not close to a base and are waiting to have it done elsewhere. Thanks, Don

Thank you. Any help would be greatly appreciated. Don:)

I might have put that last post wrong. I will have to see it in writing before I can apply for the band because the nurse won't waste her time until it is in black and white. I figure they will wait until January 1. Don't know why but the military seems to do things that way. Is your rep able to get you approved now? If so what is she using for support for approval? If it is a document? Could you post the web address so the rest of us can get our journey started. Thanks, Don