minpinmom

When I read that I thought it meant that it is Excluded - meaning they don't cover it? Am I wrong?

I just called their general surgery dept and asked if they did LapBand, the lady said yes, and I asked what I needed to do to get an appt, she said you must live IN San Antonio - I said I lived in Houston, but that Wilford Hall was the closest MTF to me, she said it didn't matter, they will only approve if you are local - and she said I didn't "sound" old enough- she said you have to be 50 years old to do it. GO figure. I also contacted Brooke (Army) in San Antonio, they said they don't do them, but they are about to start - I am going to call back on Monday and see if I can get their requirements and get on their list. Ft. Hood does not do them and neither does the Naval Base in Corpus Christi. (I did a LOT of calling today) Hope this helps someone out there.

I just called Wilford Hall, the MTF in San Antonio, TX, they DO LapBand, you must live in the San Antonio area (I am in Houston and they said no way) and you have to be over 50 years old. Just thought I would pass along the info

I've got a question . . . I went to my Dr., he put in the request for me to see Dr. Spiegel and said now we have to see if you get approved. That was July 5th. Online it shows I was approved for 6 visits to Dr. Spiegel for "Obesity" on July 11. Does this mean they have approved me for the surgery? Or just to go see him? 6 visits seem like a lot if it isn't for surgery. I have Tricare insurance and was wondering if anyone that has gone through this knows. From what I have read, it normally takes a lot longer to get "approved". Thanks for your help and advice.

If you look at the Tricare Standard policy manual (online) is says that it is limited to RNY, Gastric BYpass and Gastroplasty. When you look at the Tricare Prime it says Obesity Surgery requires a psycholical evaluation - so, I am hoping my psych eval shows that I am looney and alllllll of my worldly problems will be solved by the band :-) ok, well that may be stretching it a bit. If I get denied, and my appeals fail, I will dig deeper into Tricare Standard, but I don't hold out too much hope. However, even the Tricare representatives say that the policy is due to be updated in Jan 07. That is really that far away. W

I have had my psych eval and have gotten in most of my medical records. I am still trying to find a nutritionist/dietian that can get me in. Then we submit and fight fight fight. - or so I hear.

I don't have any answers for you, but I will be very interested in reading any replies.

I am so sorry you have had such a hard time. This is just what I am scared of. Tricare has approved my visits and requested a psych eval and a nutritional eval - I have this fear that everything will fall through right at the end. I hope the best for you.

I am sooo jealous - I don't have mine planned yet, doing the psych eval and nutrition, etc. right now. I am so excited for you. Please keep giving us a day to day inventory of how you are doing.

I feel so sorry for you. I am facing putting my cat down - and it is so hard. I live in Conroe - what about scattering his ashes at the lake? I have heard of people having pottery - vases, etc, made from their pets ashes.

Thanks for responding, that makes me feel better - doesn't seem to difficult. I have been calling Dr.s today for my psych eval - most don't have appts until December - wow am I in the wrong business. Hopefully the Nutritionist wont be so bad.

My insurance is requiring me to go to a Nutritionist before they will approve me - so I called my insurance to find out who in my area is available - and they tell me that don't cover Nutritionist - for me just to go to my PCM - - - a month ago this would have sounded strange - after dealing with Tricare daily - it seemed perfectly normal :-) My question is - would you pay out of pocket and go to a Nutritionist or just go to your PCM? Also, what is evaluated during an evaluation? What did you guys go through?

Well, I can't believe it, but Dr. Spiegel's office called today and they said that Tricare will pay 100%. I have to get a psych eval, go to a nutritionist and get all of my medical records. I am in shock, I can't believe it. I keep thinking that they are going to call me back and say there was a misunderstanding. What a day.

I sure will. I had my first visit with the surgeon, his office said they have done only a "couple" of Tricare Prime clients - out of 4000 in the last 5 years. So it might be hard. I met a lady at the seminar who dropped down to Tricare standard, she said they will cover 80% of the cost. So, I will fight once I get my 1st rejection, if it takes too long, I will see about dropping down to Standard. But, I will keep everyone posted.

Gina Maybe so I am in Tricare South - when I called they said they don't cover it - I kept inquiring and she said to have my Surgeon sendin the paperwork - that they send it in for case by case approval. Sounds like I have a lot of work ahead of me though. I was sooo excited when I got my referral, I thought that was all I needed. Little did I know . . .

Jennut Yeah, so far so good. I have read a lot of negative on here, but so far everything is fine. GinaJ Tricare says they cover Lapband on a case by case basis. The lady I spoke with says that since I actually got a referral for office visits, the surgery referral shouldn't be a big deal. I should know more tomorrow, I go for my first visit with the surgeon. Thanks for all your help and advice.

At what point do you know if you have been approved or not? Dr. Spiegel in Houston ONLY does Lapband and I just got my referral in the mail saying that Tricare has authorized 5 visits. WTF would I need 5 freakin visits for if they dont let you have the surgery? WTF

I work in a medical office - I run the front for 9 therapist - and when someone REALLY needs to get in we make an exception. I would call and ask to speak with the Office Manager, and explain that you understand how busy they are, but that you are unable to wait that long for a fill. Ask to be put on a cancellation list and then call every morning and every afternoon to find out if they have any cancellations. Whomever you speak with the first time, ask for her by name, it will help make her accountable.

I haven't had it yet, but I have told EVERYONE I know . . . I am yelling it off the rooftops! My first appointment got moved up from this Thursday to this Wednesday and it sent me back to the rooftop. Everyone has been super supportive, a couple of people seemed concerned with the surgery and complications, but that is because to them all WLS is Gastric Bypass. My strategy is . . . if I tell everyone, I will be more accountable then if I kept it as my little secret. I want to succeed at this more than anything. I hope I don't regret my decission.

I haven't had wls yet . . . but I have had a huge tumor removed and I have a 9 inch scar from my belly button down. I had the surgery in 2001 and it has faded so much now, that it isn't even noticable. And trust me it was freakin huge! I was worried afterwards how my beau would react, but lol, I could have written in glow in the dark ink all over my stomach - and he wouldnt have noticed - wear some sassy lingere - he will never know what hit him! Also, you don't have to share everything with someone at once - if he ask whats the scar from - ask him if he would rather talk or . . . . . . use your imagination :-)

That really sucks . . . dare I ask who your dr. is?

I am 5'4" my Dr. said that 5' should be 105 lbs and 5lbs more for each inch. So I should be 125 - far from what I weigh or even what I want to weigh. I have never been thin, but I would like to be like a size 10 -12 I want to shop in Normal stores. :-)

I am an Army Brat, Air Force wife (retired), it shows (now) that they do cover it if you meet the requirements, and my PCM put in a referral saying that I meet the requirements. I called Tricare and asked them what the referral was for specifically - and they said for Obesity - I guess I have to wait and talk to Dr. Spiegel's office. Did you like Dr. Spiegel? I have read just about every thread on here and a lot of people didn't like his staff - what was your experience.

Hello all! I have been reading this site for a few weeks now. I have gotten so far as to get the referral from my PCM - awaiting authorization through my insurance (Tricare) You guys have given me so much support - lol, without you knowing it. I just wanted to say "thank you". My referral is to Felix Spiegel. After reading so much, I know a lot of you have been banded by him. It has been great to hear your perspectives. Hopefully I can tell you all soon that I have my authorization. I soooo want to be a part of the "banded crowd" :-)

Thank you guys . . . I have good news . . . I think, online I show that I have been approved to see Spiegel for 6 visits - I hope that means that the surgery is approved. I am going to his seminar/consult next week - at least I know that will be paid for. I have been floating all day today. :-)