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For those of you who are planning to use TRICARE Prime, today I discovered the stipulations and thought I would share. I am required to see a dietician and exercise expert for three months and receive a psych evaluation. Of my dietician visits, I must visit at least once with the dietician on base.
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Tricare Prime: MTF Provider at Fort Jackson or Fort Benning
cozy21 posted a topic in PRE-Operation Weight Loss Surgery Q&A
Hi everyone! I am fairly new to app and appreciate all of your advice. I am currently covered under Tricare Prime and have been working with a civilian provider. Everything has been going very smooth. I originally decided to get the Lap Band, but after talking to several other patients, attending support groups and information seminars, and doing a lot of soul-searching, I've decided that the sleeve will be a better option for me. As many of you know, Tricare does not cover the sleeve surgery at civlian providers, but they will cover it at an MTF. I refuse to go to the surgeon at Winn (the MTF on the post we are on) because I had an AWFUL experience with him. He is the reason why my husband and I requested a civilian provider. I am half way between Fort Jackson and Fort Benning and am willing to go to either of these facilities to get the sleeve procedure. I was curious if anyone knows any MTF bariatric providers at the on-post hospitals on either of these bases? If so, please let me know. It is a four hour drive either way for me and don't want it to be a waste of a drive! Please help me! -
I am just finding out that Tricare won't cover the sleeve through a civilian surgeon. Balboa in San Diego is the closest military hospital to me that does the procedure. It is 5 hours away from me but I guess that is doable. Does anyone have any experience with them, I would really love some help with this process. Who I need to talk to, what questions to ask, how much I can get done locally so I don't have to drive that far a bunch of times. Thanks in advance to anyone that can help me out.
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So today was the day for me to return to the doctor to review my labs to make sure i was a go to see the surgeon. i have tricare prime so u had to get my doctors approval. I received a call yesterday stating that my doc wouldn't be in because of a family problem.....ugh i was so nervous! I was sure that the doctor covering for her would want me to wait until she returned to get my referral. The doc same in saying that he wouldnt give me the referral, and that i would have to wait until my doc returned. Then his nurse stated that my doc wont be in for 2 month, and so he put it in. He told me to wait 5 to 10 business days to hear if the referral was accept. but in only 1 hour i go a call with a date for 2/14 to see my surgeon! how fast was that!!!! Im so excited, nervous! Now what should i expect?
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How Do You Survive The Waiting Period (Before Surgery)
☠carolinagirl☠ posted a topic in PRE-Operation Weight Loss Surgery Q&A
as some of you know, I have 5 more months on my doctor supervision before I can have surgery..which does depress me and upsets me and really makes me feel...I am being punished somehow bc of how I look...but I know and realize (via reality) setting in about it. But for anyone reading this who has also had to wait, please give me (and whomever else has to wait also) ideas, any thoughts on how I can hang in there bc sometimes, it seems like forever...and a day -
Hi there! My husband just recently retired from the Navy... So now my life has some kind of stability... So that being said, I finally had the courage to ask my pcm that I was interested in bariatric surgery. I have asked 3 pcms prior to my current pcm at Kimbrough for a referral to General Surgery and with them being Army docs and nurses, they ALL said to diet and exercise, like "they" do. I was afraid to ask AGAIN after failed attempts to go to the gym (you think I would have the courage to go to the gym after the feds eliminated my position in April!) and eating right portions,but my PCM noticed that I gained 50 lbs within a 2 year period and steadily climbing up. Yes, did all the testing, thyroid, diabetes, but I just have PCOS and HBP (being managed by meds) and being fat just runs in my genetics. Overall, per my pcm (though she didn't say fat, lol), I'm "healthy" but fat. Diabetes and thyroid issues run in my family though and she wants to prevent that from happening. I'm about to call the Bariatric Dept to see what my next steps are... But I was wondering if anyone out there who has gone through any weight loss procedure with Walter Reed/Bethesda? Or any MTF? I have gone through their website but still have many thoughts, questions... Overall, MTF care is way, way different than civillian care and have had nothing but excellent care done with military treatment facilities. Sometimes you hear horror stories about MTF surgeries but I have faith in our military system. I really, really would like to hear from you if you had the surgery in an MTF or also thinking about it too!
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I'm not looking for a quick fix, I'm looking to prolong my glorious life. Being the gestapo I am, I googled the crap out of bariatric, and after getting the green light from my husband - I made my decision. Called Tricare (I have Tricare Prime) and they told me what I need to do to get it approved. Can I tell you how crazy excited I was to find that not only do they cover bariatric surgery, there is a good chance that I will pay NOTHING. Wait....WHAT....like zero dollars??.. ..is this real life!??!?!???! About a month later, we went home to Austin (hubby was stationed at Pearl Harbor, Hawaii at the time) for Thanksgiving vacay. I was going to call and schedule Dr appointments and get the ball rolling after the new year (2012). BUT the universe had other plans. On Jan 11th 2012 (our 1 year wedding anniversary , we found out I was pregnant. So here I am now in SE Georgia, husband is deployed, with a six month old. Had gestational diabetes during my last trimester and was on a diabetic diet until my son was born. I gained about 35 pounds during my pregnancy and was able to shed 15. I know I probably was smaller than that a few weeks after but I have been steadily gaining now hovering anywhere in between 259 -264. Aside from the day I gave birth, this is the largest I have ever been. Of course I like the idea of not being plus size and lookin all thin and stuff but my health is the now the driving force behind me deciding to actually do this. I am so scared of getting full blown diabetes. Because I had gestational, I have like a million percent chance of getting full-blown diabetes if I don't lose the weight. My most recent weight loss venture has been weight watchers. I could see how a person could have success with it but it's just not working for me. Oh yeah, did I mention my sister is a licensed personal trainer/nutritionist/crossfit instructor? And a ex-boxer? She is almost 100% lean muscle and is in NO WAY supportive of this. I told her last time back before I got pregnant that I was considering it and she flipped out. Told me that I don't need that and that it's a lazy person's answer to a life long problem. Whatever skinny butt! Go off now and eat your paleo crap burgers. That being said, I love my sister dearly and appreciate her concerns but it's my life and my decision. I've always been the type of chick who threw caution to the wind and just went with it. Some would call me brave. I don't think I'm as brave as I used to be. Funny how a husband and kid change things like that. I think twice now before I do or say anything. Especially, since my hubbers is in the Navy. Can't let my mouth go and get me in trouble. I had my very first appointment on Monday 2/25/2013 with my PCM to get a referral to a bariatric surgeon in the SE Georgia or Jacksonville area. She is having me go and get my blood sugar tested (since I haven't after having my son), then I will meet back with her in a week. Got an email today from Tricare telling me that my referral to the surgeon has been approved. I know that after meeting with him he will be able to help me make the decision right for me. I am still breastfeeding and really want to continue breastfeeding as long as possible up to 1 year old. However, it looks like I will have to switch to formula before I have any surgery. Duh. I seriously can't imagine picking up my son and hoisting him up to nurse after surgery. YIKES!
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I'm just curious if anyone has had their band removed and then got gastric I was banded in 2009 I have an apt with my surgeon to discuss if this is even possible with Tricare insurance Any advice would be helpful
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i am about to start my fills next month. i have tricare prime. how does tricare work/handle with fills? is it still the reg copay? if you get a fill under fluorsopy, do you need prior approval?
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Starting My Labband Journey - Rough Beginnings
Beautiful-B posted a topic in Tell Your Weight Loss Surgery Story
Hello Everybody, I am just starting my journey to getting my lapband surgery. I am 5'2, 222 lbs with a 40 BMI. I am going on my 2nd month of getting setup for this procedure. I have TriCare Prime insurance. My PC doctor sent in my referral and I have been referred to Dr. Lavin at Surgical Specalist of Louisiana. I have completed my inital visit and I have completed all of my "Homework" as they call it. I have one snag that is holding up my paperwork from being sent over to Tricare for final approval.. My Thirod levels are out of whack. I was diagnoised with Hypothyroidism about 3 months ago and I was prescribed a 25 mg dose of Levothyroiod and I took it for a few days and stopped. I felt no difference and figured, "What's the big deal!". Well I'm here to tell you it is a big deal. The surgical office is holding off sending in my paperwork until my levels are ok. That makes me crazy. I have restarted the medications, again still no diference in how I feel. I have went back to have my blood drawn again after two weeks of taking the medications and my doctors office will not give me the results over the phone. It's been about 4 days since they had the labs and I was told a letter was mailed with the results. Guess what, I checked the mail today.. Still not letter. I am feeling so discouraged right now. The surgical office said their hands are tied and it's up to me and my PC doctor to get my levels stable. I am so close to having my packet sent to the insurance, but yet so far. If anyone can offer and words of encouragement. It would be greatly appreciated. Thank you, Beautiful-B- 9 replies
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I went to my seminar and had my pcp draft a referral to tricare. And the baratric office told me toady that tricare wants me to wait 6 months?? Anyone know about tricare?? Help??
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My daughter is getting ready to begin the approval process with Tricare Reserve Select. Will be 18 in June. What kind of out-of-pocket expenses should we expect? Thanks so much....
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Finally took my first steps on this long journey...
hittpants11 posted a topic in PRE-Operation Weight Loss Surgery Q&A
I joined this forum back over a year and a half ago because I was seriously considering getting banded. Did my research, googled the crap out of it, and after getting the green light from my husband - I made my decision. Called Tricare (I have Tricare Prime) and they told me what I need to do to get it approved. Can I tell you how crazy excited I was to find that not only do they cover LapBand surgery, there is a good chance that I will pay NOTHING. Wait....WHAT....like zero dollars??.. ..is this real life!??!?!???! About a month later, we went home to Austin (hubby was stationed at Pearl Harbor, Hawaii at the time) for Thanksgiving vacay. I was going to call and schedule Dr appointments and get the ball rolling after the new year (2012). BUT the universe had other plans. On Jan 11th 2012 (our 1 year wedding anniversary , we found out I was pregnant. :D So here I am now in SE Georgia, husband is deployed, with a six month old. Had gestational diabetes during my last trimester and was on a diabetic diet until my son was born. I gained about 35 pounds during my pregnancy and was able to shed 15. I know I probably was smaller than that a few weeks after but I have been steadily gaining now hovering anywhere in between 259 -264. Aside from the day I gave birth, this is the largest I have ever been. Of course I like the idea of not being plus size and lookin all thin and stuff but my health is the now the driving force behind me deciding to actually do this. I am so scared of getting full blown diabetes. Because I had gestational I have like a million percent chance of getting it if I don't lose the weight. My most recent weight loss venture has been weight watchers. I could see how a person could have success with it but it's just not working for me. Oh yeah, did I mention my sister is a licensed personal trainer/nutritionist/crossfit instructor? And a ex-boxer? She is almost 100% lean muscle and is in NO WAY supportive of this. I told her last time back before I got pregnant that I was considering it and she flipped out. Told me that I don't need that and that it's a lazy person's answer to a life long problem. Whatever skinny butt! Go off now and eat your paleo crap burgers. That being said, I love my sister dearly and appreciate her concerns but it's my life and my decision. I've always been the type of chick who threw caution to the wind and just went with it. Some would call me brave. I don't think I'm as brave as I used to be. Funny how a husband and kid change things like that. I think twice now before I do or say anything. Especially, since my hubbers is in the Navy. Can't let my mouth go an get me in trouble. I have my very first appointment on Monday with my PCM to get a referral to a bariatric surgeon in the SE Georgia or Jacksonville area. I am still breastfeeding and really want to continue breastfeeding as long as possible up to 1 year old. But I can't imagine picking up my son and hoisting him up to nurse after surgery. YIKES! -
Tricare Select...Does it cover the Sleeve?
thatonegirl posted a topic in Gastric Sleeve Surgery Forums
Can anyone offer assistance on if the Gastric Sleeve is covered by Tricare Select and if it is, what are the requirements to get approved? -
I'm a 59yo male, 6 days post op from gastric bypass at the Medical University of South Carolina. I thought I'd share because while the ladies are oh so willing, I had a harder time finding info from a guys perspective. I lost control of my weight maintenance when hip issues related to injury forced replacements. I'm 6'2", and at surgery weighed right at 300lbs. TRICARE required three months of medically supervised weight loss. My co-morbidity is sleep apnea (which I had at 200lbs in my younger days). I had surgery at 9am on St Patrick's day. My surgeon is from Ireland. How could I go wrong? Waking up from anesthesia, I had pain in my abdomin (8 of 10). I told the nurse that it hurt, and I had no desire to prove my manliness and that he should fix it quickly. He did, and I was fine. I spent one night in the hospital. The attending said I could go home if I was up to it. I said hell yea. That afternoon was probably the worst...who knew that gas pain could be so miserable. Went to bed early on Saturday and woke up Sunday feeling dang near normal. By some strange fate, most of my aches and pains seem to have disappeared. I thought it was the meds, but they haven't returned. I took It easy on Sunday. My boss called to check on me, and I told him I'd be in on Monday. He ixnayed that plan, so I waited till Tuesday. I'm a heavy construction superintendent these days. After about seven hours of superintending, I became desperately sleepy, so I headed for the hacienda. Since waking up Wednesday morning, I've felt ten years younger. I've lost 10-12 lbs since surgery. Ill be glad to answer any questions if I can help anybody.
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Going to talk to the doctor about the band...
TheDuchess posted a topic in PRE-Operation Weight Loss Surgery Q&A
Back in 2009 I was on board with getting banded, and didn't have much further to go. Two things came up, we were misinformed on our insurance (Tri-care) and it's timing, as we had been told that we'd still have 3 months after he returned home of being on the insurance, my husband is in the Guard. The second had been that my doctor was concerned that my issue with weight loss may have something to do with my hormones. We were able to show it wasn't my hormones, and that my body survives on a low calorie count (1200-1500 calories a day maintains my weight) and having come to this conclusion it seems like the lapband is a good investment for the long run of my life, considering we haven't even begun to have children yet, and I can't imagine how difficult it'll be to get the weight back off without some sort of tool to help. In 2009 I didn't end up getting the surgery, it seemed realatively easy at the time to get it. I'm nervous now, nearly 4 years later, to go back and talk to a NEW doctor about this. Any advice? Is it more complicated now to get approved? Did anyone else go back some time later and decide to get it after deciding NOT to get it? -
I received approval to be seen at INOVA for 6 visits. Does this mean I will have to wait for another approval for surgery, after these appointments are completed? If during these 6 visits, I drop below the 40 bmi will I be denied?
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I was just wondering if anyone was around where I live that was going to be sleeved? Or is there any other military insurances users that can tell me more about how the military process is done?
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Johns Hopkins/tricare Headache! Anyone Have Advice?
IMakeArmyBrats5 posted a topic in Insurance & Financing
Hi there! I am throughly lost and no matter who I "officially" speak to, I get mixed answers. I was hoping to find some help here. 1. I am enrolled with US Family Health Plan-a Tricare Prime beneficiary plan, I'm in Marland, Ft. Meade 2. I make the 200%/over 40% BMI requirements of Tricare, 5 foot even and 243 pounds, small frame 3. I have some other issues such as severe GERD all my life (been overweight whole life too), asthma, osteoarthritis of spine, and family history of diabetes and stroke before age 50 (something my PCM says is a big red flag) Here's the problem: They are wanting me to do this 6 month supervised "diet" which is basically anything I choose, but monthly weigh ins. If I lose too much, they wont approve me, if I don't lose enough they say I'm not trying and thus not showing initiative to the life style change that lap band requires. I pulled up the policy for my insurance it says USFHP Tricare Policy Manual Chapter 4. A. BMI equal or greater than 40 or 35 with comorbidities AND patient was previously unsuccessful with non surgical medical treatment for obesity must be documented But then it says right after that Patient has evidence of either of the following: 1. BMI greater than or equal to 40 2.BMI of 35-39 with comorbidty DOES NOT SAY ANYTHING ABOUT DIET RECORD! Nor does it say ANYWHERE about a 6 month diet! I've called my insurance, but no one ever has a straight answer, and I don't want to go lose weight and then they don't approve me, that would be 6 months of waiting around for nothing. Three of my friends and family members were approved in less than 2 weeks (some within 48 hours) without any diet (they were just on Tricare), even when they didn't meet the 40 BMI or 35 with comorbids. What am I doing wrong here? -
First I want to start off with a little about me. At the age of 22 I am hppily married to a US Army soldier, stay at home mother of 3, and love to be out n about doing stuff and hanging with friends. I had to put education on hold till i find a reliable sitter but i am slowly working on my RN. My husband and I choose to stop having children so I am taking this time to work on myself. I start to look into the lap band because: !. I have fought with weight my whole life 2: i want to live a betterlife for my children and teach them to live to healthier life 3: with the last like 20 pounds i started to really noice the effects like getting out of breath quicker, knees hurting all the time, and clothes just not fitting at all 4 this is what broke the the "fat straw" i weigh more now than i ever did when i was pregnant. so March 6 2012 i went to my seminar, March 16th met with the NP and mental Health Eval, March 19th lab work and upper gi, April 5 nutrionist class/ first WLS support group April 13 surgery approval.... April 26th Stars pre op diet. and May 10th Surgery Now I have heard some awful stories about gettin approved for WlS through tricare (tricare south prime!)... i am guessing it as farely easy for me because i had already been working with my PCM for sometime and i met the more that 100 pounds over wieght. I mean it took them less than 24 hours to approve the request.the only co morbidity i have is bad knees and if i dont change i am on my way to diabetes. The biggest question I have "Are you scared?" no i am not scared to be changeing my life. i am excited. i am scared about the mood swings i will have with on the pre op diet but thats about it,\
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Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy
samakar1516 posted a topic in Insurance & Financing
I read in a post on this site recently that Tricare retiree beneficiaries did not have to go through Tricare to have the surgery done in an MTF. That is not necessarily true, at least in the North Region it's not. Womack at Ft. Bragg told me that we had to have a referral put in through Tricare. My doctor supposedly put the referral in requesting the MTF, but it came back approved for a civilian doctor, but of course Tricare does not cover the sleeve gastrectomy. I was also told by some at Tricare that all I had to do was to call Tricare back once it was approved and tell them that I want the MTF. Well, I tried doing that today and was told that they just can't change it, they have to put a request in to see if there was space available for me at the MTF. I told her to go ahead and do that then, so now I have to wait and see if it comes back as the MTF approving it or not....what a bunch of drama! If TRicare comes back telling me that Womack (MTF) disapproved it, I will be on the phone once again to Womack to see if there is a way I can get in there to have the procedure done. T His is ridiculous; it's like once you've retired you're put on the back burner and basically forgotten about....which is sad. If anyone's interested I ill keep you posted on what happens. Of course I probably won't hear anything till next week because of the holiday now. -
beginner and would love to know your story.
Mrs. Goodridge posted a topic in PRE-Operation Weight Loss Surgery Q&A
Hello everyone. Im new to the sleeve group, never considered it to be an option until giving it more of a look. Yesterday i went to meet me surgeons to see if he would accept me into their program. he was a very lovely person. calm, patient, and he let me talk. Everything was fine, and we were going over what to look forward to when he looked at my chart and say that i was only 24. He made it very clear to me that he doesn't like to operate on anyone 26 and under because of their immaturity. But after about a minute he said that theirs a difference in maturity between and 26 yr old with no children, than a 24 yr old with 3 children ( which is myself) and he accepted me into the program. I was so happy (not that i let it show) I have tricare prime (military insurance) so its nice to know my surgeon will be there every step of the way. He told me that he would only do the sleeve for me being that im young and motivated. I WOULD LOVE TO KNOW YOUR SLEEVE STORY. I will be having surgery in july, and im nervous, scared, and excited all at the same exact time. thank you for your support and story -
after all my pre-op requirements and finally getting the clearance letter to the clinic to submit for approval, Dr Enochs office just told me I now need to schedule a sleep test. THEY TELL ME THIS NOW? can you please tell me what this is how it works and (I have seen on here about people failing it). please advise as I am very distraught and upset as this (new item) that is now sprung on me.
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I thought I'd note my experience with Tricare Standard (West) and removal of the Lap Band. I've had it since 2007 and lost a fair bit of weight (75#). The past month though I went mostly vegetarian(fish one night a week and meat on one other) and dropped another 15#. Then my port flipped on me. The doc said it was most likely due to weight loss. Had some lower GI pain and blood in the stool same day as it shifted which freaked me out initially. Anyway, I'm pretty dialed in now on portion sizes and just wanted it out. The surgeon had a xray taken for my visit. Tricare did approve the removal in two business days and had it out the day after approval. I had read on various forums before that they won't take it out but with complications it seems to not be a problem. They don't last forever. Good news is it was intact and "hadn't come apart" although I did have some scarring. He said he's taking more of them out now than he's putting in.
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pre-surgery Army Vet - 1st Appointment in a week - Nervous/Excited
MKL posted a topic in Gastric Sleeve Surgery Forums
I am a Retired Army Medic. I still have Tricare and my provider & I decided that the Gastric Sleeve would be a good tool for me. She referred me and my 1st appointment with the special clinic at the Military Tmt Facility is on 04 Jan 2021. I am excited, but yet nervous about all the unknows. I have no idea what the process will entail as it is at the MTF. I do know that unknowingly I have already completed a lot of the pre requirements for surgery looking for answers to medical conditions I am already dealing with.