mmbell

Hi all.....I have Tricare Standard and last year I had my consult and at the time Tricare would not pay unless it was done in an acute care setting...so now my weight loss center built one and are now accepting Tricare clients. I am currently waiting on insurance approval as of last week. Last year I know they ran me through and I qualified and could have even sworn that they sent me a letter giving me the ok for the surgery but this year they have to request all my medical information. I am inquiring to see what comormidities helped you qualify with Tricare. I have hypothyroidism and the coordinater at the weight loss center said that was one...I also have acid reflux with hiatil hernia. Thanks for any input anyone can give me!

I am very frustrated today. I went in for my consult at Weight Loss Surgical Center in KC last November in which they checked to see if my insurance would pay and I received a phone call saying they would pay but it had to be done at an acute care facility which they did not have but were in the process of building one. Fast forward to a month ago and I called to check on the facility and if it was completed & they had just done their 2nd surgery there so the ball starts rolling again....get phone call to set up another consult OR pre-op visit. I was on the fence whether to do it or not and after joining this group and reading the success stories I am 110% committed so left 2 messages to set up pre-op consult and the person that gets insurance clearance had been calling me WEEKLY to update me on Tricare's requirements that were being met each week SO I think as soon as the facility meets Tricare's requirement I am a go....NOPE....now I'm told that my BMI is under 40 and I do not have the 2 co-morbidities to qualify. WHAT!?!?! Talk about popping someone's bubble fast that was ready to get this going..........so now I wait as they try to gain clearance from Tricare. Why would they tell me last year that they would defniitely pay for it and now possibly NOT? They had the same requirements last year that they do today. Very disappointed & upset. Anyone else have to deal with Tricare? Do they pay for your fills as well? I have a $1,000.00 family deductible which I met last year from being in the hospital twice and if I could have had this done before Oct 1st I would not have had to pay a dime! But my health is worth the $1000.00 at least and I just want to do this and I think if I'm denied I will really fall in to a deeper depression...I don't want to have to eat until my BMI is over 40 to get the surgery so I may be left of my own. I lost 84# once before but its all back and then some. They think my thyroid issues will count so they are going to run it by Tricare. Thanks for letting me vent and if anyone has Tricare just wondering how they were getting them to pay for your surgery!

After reading everyone's comments and others blogs...I am full force ready to do this...on board 110% but VERY frustrated right now. Finally got a return phone call from the insurance director at the wt loss center and NOW I do not have the 2 co-mordities to go along with what my insurance requires and my BMI is under 40. Its frustrating as last year they called me when I did a consult and said that I was approved by my insurance but until they built their acute care facility they would not pay. The WLSC has built & opened the facility just a couple months ago and NOW they tell me this info.......get my hopes up & pull the rug out from under me. I did tell the person she ok'ed me last year and I did ask this question last year "so my insurance will cover my surgery? they approved me?" and was told yes so they are looking in to it again. Please keep your fingers crossed for me and say a little prayer too....just awaiting a return call to say if I'm approved through my insurance or NOT!

Hi all! I am about 70 miles east of KC in the boonies and looking for some support. I am awaiting a return call to schedule my pre-op appt and hoping that by November I will having my surgery. Anyone else use Weight Loss Surgical Center? I see a lot of Dr Malley but he was further from me and I was just wondering how the ones that used WLSC liked the dr's. Good luck to you all and you have inspired me reading your posts. I was on the fence whether to do it or not and now I am chomping at the bit ready to go IF they would just call me BACK! :0)

HI! I am hoping to join you all in the bandsters of Nov 2010. I had my consult almost a year ago and my insurance would cover the surgery but it had to be done at an acute care facility so a couple months ago they built the facility and was waiting on Tricare(my insurance) to approve their facility and I had a call 2 weeks ago saying I was good to go but I have left 2 messages with no return phone calls and getting frustrated so left a message today with the insurance coordinator to make sure it is still covered so I can set up a pre-op appt so that is what I am waiting on! I was on the fence, should I or shouldn't I but after reading several blogs on here I am all for it & excited to start my new life. I lost it over 7 years ago but gained it all back (84#'s). I hope we can keep in touch and support one another in this journey! good luck to everyone

Hi I had my first consult almost a year ago in which my insurance at the time only paid if the procedure was done in an acute care setting. Now the surgical weight loss center has built one and my insurance is ready to pay.......I received a phone call a couple of weeks ago with a message on my phone to call and set up another consult or pre-op appointment! I have tried and left messages a couple of times for my pre-op consult appt and I know once I jump that hurdle I will be on board with this procedure in a heartbeat! I am tired of feeling like a slug and looking this way. I had 2 babies 18 months apart and now my youngest is a year old...I swore to NOT buy any new clothes until I lost the weight & was able to buy smaller clothes so here I am STILL in my maternity pants! I am ready to do this and I did lose over 80 pounds 7 years ago on my own but it was the wrong way...constantly exercising & starving myself but with life stresses its back and I'm ready to LIVE AGAIN! Please help me get on the right track & I'm anxious to make some new friends and have some cheerleaders that are further in the process then I as well as do some cheerleading of my own for you all! Thanks for reading!