Rsilversea

Tricare has requirements for certain co-morbidities. These include hypertension (high cholesterol), high blood pressure, and osteoarthritis. Their policy states which co-morbidities are needed. Your best bet is to talk to a Tricare representative.

Don't stress about it. Just talk to your surgeon and let them deal with it.

Same here. Could be maintenance problems but then I'm no computer expert. Computers are like cars to me. You know, insert key into ignition, turn, and car starts. If it doesn't happen, I freak out.

This is what a lot of us need to hear! Thanks for posting.

BMI is NOT in their policy although the policy is currently being rewritten. It may take 6 months to a year for the change to take place though.

Doctor's appeal letter is going in today.

Doctor's office is sending in appeal today. They are using the weight I was when I was first weighed and my correct height. Haven't received my denial letter so I haven't sent in my appeal. Hopefully I'll have good news by the beginning of next week.

Ho ho ho? :thumbup:

I'm working on my appeal letter today. They have 30 days to respond but my doctor's office said they normally respond in five (I'm guessing that's "normal" insurance companies not Tricare). Hopefully I'll know by the end of next week or beginning of the week after.

Until Tricare updates their standards, you will never get approved on BMI alone. I don't suggest gaining the weight just to get the surgery because I believe it will harm you in the long run.

So po'd! My doctor's office never measured my height so I was denied by Tricare. Now I'm officially 12-20 pounds under their current standard for surgery approval. It doesn't look like I'll be getting surgery done even though my BMI is 40 because Tricare is behind the times with the rest of the nation. They still use the outdated MetLife height/weight chart! Spitting mad and depressed. Hubby just wants me to lose it on my own and can't comprehend how difficult that is for me. So now we are arguing. He thinks I'm giving up on losing weight (and he may be right). I can't reach my nurse at the doctors office and don't know what to do.

Well, as I stated in another thread, I was denied but my doctor is going to call Tricare. I've been told that once the doctor has spoken with insurance companies, they usually give approval. I hope so since I've been stressed out about this.

Well, I was just informed that I was denied. My doctor is going to call Tricare and give them hell, lol. Apparently they are rewriting the policy but it won't go into effect anytime soon. I may have to go through an appeal process but I hope to find out something more definitive from the doctor by the end of Thursday.

My doctor has also scheduled my surgery in advance of approval. He's never had problems with anyone with my insurance getting approval but they are dragging their feet in my case. My doctor is thinking he will have to reschedule my surgery and if, by some bad stroke of luck, my insurance denies me he's going to appeal.

It's been almost 2 weeks and I'm still waiting. My BMI is 40 and I'm in the ballpark for Tricare's policy but they are haggling over something. No clue what and my doctor's office is frustrated with them. So am I. I may have to adjust my surgery date because the doctor's office can't get in touch with the case manager and they needed an answer by noon today. It's past noon and I have not heard anything.

Sounds like it's time for a new boyfriend. Sorry to be blunt but he doesn't sound like a winner.

I haven't had my lap band surgery yet but I have had my gallbladder removed. From what I can tell, they are done the same way and my surgery was pretty easy.

Venting helps to so vent away. And maybe you have a support group nearby you that can help? Also try talking to your doctor. He may be able to give some advice. I certainly understand stress and "not caring". I'm under some stress since I'm still waiting on approval from my insurance and it seems to be an uphill battle (certainly nothing compared to what you're going through!) You obviously care since you are (a) posting here and (:eek: are worried about gaining weight.

I haven't told any of my family. I have told my husband's family as they are supportive. My feeling is, if they can't or won't support you, find some friends who will. Also, attend your support group. They will be a big help.

I apparently don't have any co-morbidities (because they aren't treatable yet). My BMI is over 40 but my insurance (Tricare) is not consistently applying the rules to everyone. My surgeon has sent me everywhere trying to document possible co-morbidities for me. Talk to your surgeon, as he may do the same.

I know my insurance won't cover cosmetic surgery unless it's medically necessary.

Still fighting with Tricare. Had to get some x rays done today but I doubt that will help. Now I won't know more until Monday at the earliest and hopefully no later than Wednesday.

The most frustrating thing about Tricare is their lack of consistency. Some people are approved or denied based on BMI and others have to go through old standards. I just talked to my husband who e-mailed my doctor the Tricare policy because Tricare is trying to hold me to the old standards. I had to get re-measured and reweighed today PLUS I have to get x rays done on my knee and ankle to see if I have osteoarthritis. Apparently my other co-morbidities are good enough for Tricare. Heaven forbid I'm trying to better my health and keep them from paying out more money later for other surgeries and medications. (rant completed)

Oh wow! I have to go see my doctor tomorrow to get measured since Tricare is being fussy. I hope I get approved too. The doctor is going to do all he can to make sure I do. I'm even getting a photo ready to take with me because the nurse said Tricare asked for one! I sure wish Tricare was more consistent. My nurse told me she had other Tricare patients and as they met the standards, I should too. Hubby is stressed big time. It's starting to rub off on me. Congratulations!

Hah! I've told everyone BUT family, at least mine. I don't need to hear my dad's "advice." My husband's family is supportive at least.