drm1123

Congratulations! I just hit the 1s too,,, It feel great!

It all depends on your surgeon and how his "program" works. I actually went to 4 seminars, in 2 of those you were released the same day, the other two were overnight. I stayed overnight and have no co-morbidities.

This will actually be my third seminar. I first went to one in DT Brooklyn, turns out they didn't accept my insurance, so I wised up (or so I thought) and called NYU prior to my seminar, made my appts etc. and after calling to confirm that my insurance was ok I was totally disappointed. NYU is all about the money. All they keep mentioning and asking for money up front even if you have out of network insurance. To begin with my nutritionist/phych/surgeon consults were out of pocket (490, 250 and 250) thats almost $1K and I hadn't even started. On top of that they push you to get the liquid diet stuff from them. Another thing is that I read that the NYU drs are in trouble for using unlicensed practitioners. Anyway, I've done a lot of research on Dr Roslin and Lenox Hill Bariatric and it is all excellent. The staff was nice to me too. And by the way the psych eval there is $100 less than NYU plus the nutritionist is free. They have excellent pre-op and post-op services. So to say the least I am very excited, starting my journey all over again and I look forward to getting banded at Lenox Hill.

Yes I was banded on 9/9/10, however, I changed surgeons. My surgeon was Dr. Julio Teixeira at St Lukes Roosevelt. I have lost 32 pounds and I just had my first fill.

Tricare is not as bad as people make it seem. I have Tricare Standard. My first seminar was June 1st, I changed surgeons twice and still got banded Sept. 9th.

I just got my surgery and I don't forsee this happening to me partly because my husband and I split before my weight gain and my friends have seen me all kinds of sizes so now when I lose weight they will probably make bets on how long it will last. However, what is happening to you has happened to many people I have met in support groups. I believe it all comes from insecurities of both your friend and your husband. However, this time is all about you now. Do what is good for you, love yourself and don't play into their games and insecurities. I recommend you attend support groups and also if possible seek professional help, i.e. family therapist, psychologist... it helps

My surgery was on thurs (9/9) and just today i'm feeling somewhat better. The worse pain was the gas and the throat. I went to an ENT dr. yesterday and there is a lot of inflammation in the throat which is due to the acid in my stomach. I have a single incision in my belly button and today for the first time I was able to bend and pick up something I dropped on the floor so there is progress. I've had to get all of my meds either soluble or chewable all because of my throat. Tomorrow is my 1 week follow-up and hopefully i will be ok to drive.

I'm getting banded tomorrow, well later today since it's after midnite. I'm so nervous about the surgery. Been on clear liquids for 2 days and i'm so hungry, i'm hoping this hunger goes away since i'll be on liquids for another 2 weeks.

I have 1st appointment with the surgeon on 6/16/10 as well as the nutritionist, however, the psychologist they work with cannot see me until 7/7/10. I have Tricare Standard (North) and I'm wondering if the psych eval is required for approval. I'm hoping this won't delay my surgery! :frown:

That's great to know. My appt with the surgeon is next week and the psych eval 3 weeks after that. I just didn't think it was fair to have to wait for the eval for my insurance process to begin. Thanks.

Congratulations! I wish you the best.

I'm still confused about it. The manual in 2002 stated that the 200% was based on both the lower and higher end of the met life chart weight for your height and frame. This didn't make sense to me because if you have to double the high end you more than double the low end. From this I understood that for a 5' 3" and a small frame my weight should be 248. This provision disappeared in the 2008 manual. So what does it mean for me. Can someone tell me.... what exactly are they looking for? Do I have to double 111 (low), 124 (low) or somewhere in between. I don't want to take a chance of getting a denial since it takes longer to appeal. Can anyone who got approved via the 200% tell me how much they weighed and what frame when they got approved. There is a proposed federal change coming up where tricare will catch up to other insurance companies and go by your bmi and also to cover the vertical sleeve, but I don't really see that happening this year. :thumbup:

I'm a little confused :thumbup: about Tricare policies. I know that regardless of being 100 pounds overweight or having a 40 bmi you do not get approved unless you have a co-morbidity. So that leaves that option out and I'm hoping for the 200% of my ideal weight to get approved. I have a small frame and definitely make the 200% on the starting end but I am about 8 pounds away from the high end. Now Tricare manual 2002 had the following provision: B. In determining the ideal body weight for morbid obesity using the Metropolitan Life Table, contractors must apply 100 pounds (or 200%) to both the lower and higher end of the weight range. Payment will be allowed when beneficiaries meet all requirements for morbid obesity surgery including the ideal weight within the newly determined range. This provision is not listed on the 2008 version of the manual. What does this mean for me? Does mean as long as I'm somewhere in between I will get approved? What has the experience of others been.

Its great to know darlamaria. I hope we can share our experiences.

Well that didn't work out. The truth is NYC is not a "military friendly city" especially when it comes to health insurance. Most people don't even know about Tricare. Going to another seminar at Lenox Hill. Hoping this is the one. :thumbup:

Hi, I hope your surgery went well . I wish you a speedy recovery and I hope you are successful in your wait loss. I'm considering Dr. Roslin so please let me know how it goes. Thank you.

I have an appt to see the surgeon before the end of the month but already insurance questions are coming up. I have an out-of-network doctor and hospital. What does tricare actually pay for after they have approved you? I know that the "allowable" charge is ridiculously low (a little over $1,000). This is for the lapband alone, the hospital charges, ie. anesthesia etc. are separate). Will they cover 75% percent of that that allowed amount or the amount my doctor charges. My doctors fee for the lapband alone is $10,000. I just need to know if they will pay 75% of that or the allowable charge. I'm beginning to sad because I won't be able to afford that. No MTFs in New York City, and very few doctors accept tricare. :biggrin:

thanks. you have to be lucky with tricare and get someone who know what they're talking about. I am attending a seminar on tuesday with NYU Dr. Fielding. A friend of mine recommended him.

You are a very strong person. I loss my mom last year the week before mothers day. I was the opposite of you. I have gained almost 100 pounds and been extremely depressed. I have just recently decided to do something for myself and try to snap out of it. It's really hard to lose a parent. I lost both of mine. Good luck and best wishes.

I have tricare standard and I live in brooklyn ny. I have called around and no is accepting tricare. The only place was lutheran hospital and they gave me an appointment for the end of July. They also told me the whole process is 6 to 9 months after my appointment. I was going to a seminar at methodist hospital but when I called the med assistant didnt even no what tricare was and said no. So Im really lost here. I have tricare north. Any will be appreciated.