Military Wives Who Have Had This Surgery

[Stevie1 0]

Dearest Ladies,

I have been reading and reading and responding to some of these threads and have had such an eye opener as far as to what our civilian counterparts have to go through. My jaw drops when I read the desperation and lack of support that some of these women have to go through. I would love to start a support group for us. Support is the key to success! I know my intro here sounds a bit stuffy but girls... let's start some dialog going and deal with our issues: As military wives we help everyone else all the time. Our world revolves around our husband, families and our service. Is it any wonder we have weight issues? Let's do what we do best - take care of each other! :smile2:

[zobee 0]

Hi Stevie! I sent you a PM with a personal invitation to join us at Walking With Warriors -- a group designed to help support, encourage, and motivate military spouses.

Hope to see you there!

[Stevie1 0]

Z - I gotcha ya! Now all I have to do is find you! LOL Question in an open format? I am assuming TRI CARE covered you. How where you able to choose your surgeon? You stated in your profile your weren't impressed with after care. That's what is really getting me. Hence the support page...talk to you later and thank you for inviting me in.

[zobee 0]

I think the confusion begins in that I am not a military wife, ha ha -- so no, I used BC/BS to pay for my surgery.

My husband was in the Marine Corp and served overseas during all of Regan's administration, and then some. I started the group to support current military spouses, but anyone is welcome to join, military or no. A lot of civilians appreciate the opportunity to help our armed forces in some way.

Hope that clears that up, ha ha!

[CantB2noty 0]

What utterly amazes me is how relatively easy Tricare's process for approval is compared to civilian insurance! And lets face it, the government doesnt like to spend money, and for us wanting weight loss surgery, its pretty easy. In fact, civilian insurance companies should be ashamed of themselves.

For me personally, by the time I reached my "I'm fed up with being fat" place, I wanted surgery done yesterday, not in a year or more, with abunch of BS requirements, such as a dr. supervised diet for 6 months. Really? Because if we had enough will power to diet and succeed on our own, we wouldnt be wanting a gastric surgery of any kind!!!! Duh, lol!!!

We all need to support each, and feel a bit more sympathy for those who have to jump through more hoops than possible sometimes to get approval..

My doctor is doing a research program that I am participating in. He is keeping track of each of his patients who gave consent, on how much they are losing with whatever type of surgery they had. He is running this for 10 years total, and I have no idea how long he has been doing this. However, his ultimate goal is to use these results to press insurance companies into making gastric surgery a covered surgery for all insurances, or better coverage for those that are crappy. It might be worth asking your doctor if they are doing this as well. If this works, think how many more people will be able to obtain bariatric help if they need it! My friend wants this surgery, but it will cost her roughly 40% out of pocket. But she can't afford it, and she is about 500 lbs now, getting worse daily.....

[Stevie1 0]

CB2,

I have to tell you that TRI CARE has been amazing for this procedure. The requirements/standards were brutal but they are there for a reason. Our docs here are overly aware of the strict approval standards. But once you are in - it's 'group support' heaven! My surgeon is one of the pioneering doctors in this procedure. The University of Padova (Italy) has funded his staff and research. I was a bit gun shy at his continuous availability. He doesn't go through a secretary or assistant. He calls you, he emails you and he makes your appointments. That's on the civilian side. On the military side - we have access to Behavioral Health counseling, nutritional counseling and the Health and Wellness center. NOW.. the challenge is for those of us to educate some of the professionals (military) as to what we need as patients but all in good time. My concern on this site are the amount of folks that just don't have the after care that they need nor the proper nutritional information to get through the first moths after surgery. Screw the insurance - why are docs not making themselves accessible ? There is never a need to be so arrogant in your surgical skills that you forget that you are a human being - taking care of other human beings who need your help. Does state side TRI CARE cover all your fills and for how long? Did you have to go through your base hospital at first? How did you seek approval? I think that what I went through overseas is a bit different than what you went through on a stateside assignment.

[dontgoggilme 0]

i am a military wife and tricare prime. i have an appointment next week to see my pcm and get my referral to go see my surgeon. since i haven't actually gone through the process myself yet, i can't actually speak from experience. but what i can talk about is what a friend of mine (fellow military spouse and tricare prime member) experienced on her Quest to get lapband done.

for her, the whole thing took about a month or less. she saw her pcm (the same one i have) and asked for the referral. referral was approved in like three days. she saw the surgeon shortly after that. then she made the appointments for all her pre-op stuff. she had her's done in 08 and at that time this surgeon was not doing any kind of pre-op liquid diet so there was no two week delay there. she was banded in about a month.

tricare paid for everything 100%. they even pay for all her post op visits and fills to this day (over one year later). the only thing tricare didn't pay for was the surgeon's $200 program membership fee. so basically she paid $200 for the surgery and everything that goes with it.

all in all the process was really easy and smooth for her (insurance process i mean) and i'm hoping it'll be the same for me. especially since i meet the criteria even more so than she did.

hopefully that helps out with the questions about how does it differ for getting approved and getting after care here in the states. =)

[futurbander2007 24]

I too an an Army wife with Tri-care prime. There really was not a lot that I had to do get my band. It was as simple as meeting with my PCM, getting the referral to general surgery, going to a few nutrition classes, and meeting a psychiatrist. That was it. I feel so bad for the people who have to go through this long drawn out process to get their lives back.

I was on the low end of the BMI scale and honestly I don't think I would have qualified for the surgery in the civilian world. But because the Lap-Band was so new to our post they were pretty willing to give it to anyone who wanted it. I am not saying that is a good thing, but it has given me my life back. I have done extremely well with the band but some other people who had it done around the same time I did are having problems with it. Not with the band itself but with the whole idea of following the "rules"

Looking back on the last 2 yrs and how far I have come and how much my fellow Lap-Banders here on post have struggled I think there should be more involved with getting the band. It seems like they are giving it to anyone and everyone whether or not they know what they are getting into. So many of the others want a revision to the sleeve or gastric bypass. Like that is going to be any easier for them. I just think the selection process needs to be reviewed. But on that note I hope to talk more with my fellow military wives.

Thanks for starting this thread! Have a fantastic week everyone!!

[maarrcox 0]

My PCM made the referral , it was a week before i got in as a new paitent . At that appointment I had a psych and nutrition eval, it took four days to get report to Tricare. Within 12 hours I had approval. So from begining to banded it was 3 weeks. I am still kind of shocked at how smoothly it went. Banded Jan.4 , 2010

[pappyny 0]

I am a military wife with tricare as well. I started my process at the beginning of January of 2009. MY PCM put in the referral for me, it was approved within 3 days. I contacted the surgeon, then had to wait 3 weeks for the next seminar. Then I had to wait again for the surgeon's office to call me to make an appt. I got all my pre-op testing done, more waiting on the surgeon to get everything to Tricare. Once they sent it in, it only took 2 days to get approved. i had my surgery on March 27, 2009. So, all together the process to about 3 1/2 months. Tricare paid for everything except the $250 required by my surgeon for a pysch consult. Tricare has paid for all of aftercare. I do need to get a referral every 3 months from my PCM, but she likes to check in on things anyway so it works out okay.

Overall I am very happy with Tricare and their coverage of the LAP-BAND® and aftercare. I am hoping they will be just as willing to cover the removal of some excess skin. From what I've heard it all depends on your PCM and if they want to fight for you. Hopefully I get to find out soon!

[cmccheryl 0]

Hello everyone!! I am also a military spouse and began my lap-band® journey in December 2009 with a visit to my PCM. She made the referral and within a few days I received a call stating that I had been accepted into the Bariatric program here in Ft. Campbell. Since then, I attended an introductory workshop and learned about all of the pre-surgery and post-surgery requirements for their program. I am very impressed with the attention to detail that they put into this program in order to have their patients succeed (short/and long term).

I was told 2 weeks ago I would be called in 30/60 days with a date to meet with the surgeon, but already recieved a call this morning and am scheduled to see him on Feb 5th.

Tomorrow I begin bloodwork, and also will pick up a packet with further instructions. So far, everything has been relatively simple and I am relieved about that. I assume I will have the surgery sometime before the end of March?

(I hope that is the case anyhow, because my husband deploys mid-March and I would prefer to have him around when I have the surgery)

General Question - How long have you had to wait between your initial surgeons visit and banding?

[maarrcox 0]

I went through Tricare instead of staying on base because of the number of people waiting on the list. From first appointment to surgery was 4 1/2 weeks. I am 14 days post op and very happy with the way everythings has gone. The first 3 days were the worst but I feel really good now. Better than before surgery.

[adagray 1]

I'm not military but somehow clicked on this thread anyway. Is everyone in the military under Tricare? If so, I'm just wondering if the reason Tricare can give better coverage for WLS is because their customers stay with them longer (less changing from one insurance to another). Basically, I've heard that it is cheaper for insurance to pay for WLS in the long-run because of all the related health costs to obesity.

But, most insurance companies are looking more short-term because the typical insurance customer switches companies every two years or so. But, I would imagine that in the military (if Tricare is the only option), they could count on it for people to stick w/them for a longer time (so they can recoup the costs). Just a thought.

I'm not trying to defend civilian insurace. I wish all of the insurances would look at the long-term and there wouldn't be so much variability between coverage for WLS. Also, I feel like most of the civilian insurances play a game where they deny you on any little thing they can... hoping you will just go away. I hate to read on here when someone says they will see if they are approved and, if not, they will just pay out of pocket. That's what their insurance WANTS them to do!!! Chances are if you've come to the conclusion that you need WLS, you probably do have a medical necessity for it. Anyway, I put up the good fight and finally got mine approved by Aetna. Its silly that I had to wait a year, but I refuse to pay for something that my insurance should cover.

[MrsMoretti 0]

Do you happen to know what the standards are?? Im going through the process now and I am hoping I get approved!

CB2,

I have to tell you that TRI CARE has been amazing for this procedure. The requirements/standards were brutal but they are there for a reason. Our docs here are overly aware of the strict approval standards. But once you are in - it's 'group support' heaven! My surgeon is one of the pioneering doctors in this procedure. The University of Padova (Italy) has funded his staff and research. I was a bit gun shy at his continuous availability. He doesn't go through a secretary or assistant. He calls you, he emails you and he makes your appointments. That's on the civilian side. On the military side - we have access to Behavioral Health counseling, nutritional counseling and the Health and Wellness center. NOW.. the challenge is for those of us to educate some of the professionals (military) as to what we need as patients but all in good time. My concern on this site are the amount of folks that just don't have the after care that they need nor the proper nutritional information to get through the first moths after surgery. Screw the insurance - why are docs not making themselves accessible ? There is never a need to be so arrogant in your surgical skills that you forget that you are a human being - taking care of other human beings who need your help. Does state side TRI CARE cover all your fills and for how long? Did you have to go through your base hospital at first? How did you seek approval? I think that what I went through overseas is a bit different than what you went through on a stateside assignment.

[MrsMoretti 0]

Do you happen to know what the standards are?? Im going through the process now and I am hoping I get approved!

CB2,

I have to tell you that TRI CARE has been amazing for this procedure. The requirements/standards were brutal but they are there for a reason. Our docs here are overly aware of the strict approval standards. But once you are in - it's 'group support' heaven! My surgeon is one of the pioneering doctors in this procedure. The University of Padova (Italy) has funded his staff and research. I was a bit gun shy at his continuous availability. He doesn't go through a secretary or assistant. He calls you, he emails you and he makes your appointments. That's on the civilian side. On the military side - we have access to Behavioral Health counseling, nutritional counseling and the Health and Wellness center. NOW.. the challenge is for those of us to educate some of the professionals (military) as to what we need as patients but all in good time. My concern on this site are the amount of folks that just don't have the after care that they need nor the proper nutritional information to get through the first moths after surgery. Screw the insurance - why are docs not making themselves accessible ? There is never a need to be so arrogant in your surgical skills that you forget that you are a human being - taking care of other human beings who need your help. Does state side TRI CARE cover all your fills and for how long? Did you have to go through your base hospital at first? How did you seek approval? I think that what I went through overseas is a bit different than what you went through on a stateside assignment.