Please help!!!!!

[soooconfused 0]

I am sitting here about to freak out, and just need some help please! Last week i had a physical, and my doc "mentioned" lap band procedure. I go to William Beaumont @ Fort Bliss (my hubby is active duty army) and he looked at my weight, and height and mentioned that WB now does the lapbands. I have been "thinking" about WLS for about 6 years now, and when he said that, I decided that it is now time, im not getting any younger

Anyway, i have RESEARCHED and researched tricare primes policys, and all i can find is that they require you to be 100 lbs over weight (no BMI requirements) AND have a co-morbid. Well I do have high blood pressure, and Im going to find out if i have high cholesterol and blood sugar issues. (in other words im pretty sure i qualify with the co-morbids) HOWEVER...........according to the metlife chart i see, they have a range for my height of 5'6 as 140 - 159. I currently weigh 248..............so Im "with in" that range. But i saw a conversation on here somewhere (wish i could find it now!!!!! ) where someone said that they require you to be on the HIGHER limit of your range. If that is the case, I would be 11 pounds shy of qualifying.

Does anyone have experience of getting lapband, under tricare prime AT A MTF???? Meaning not referred out, but at the actual army hospital?

Now that Im very excited about getting qualified, I just want to cry that I could actually be denied because im right in the middle of my "height range"????????????? I dont' see the doc for another week, and i just don't feel like im going to make it..............lol............please someone HELP!!!!!!

[Rsilversea 2]

My husband is AD military and I'm scheduled to have surgery May 5. Just waiting on Tricare to approve. From what I have heard, you must have a BMI higher than 40 (mine's 41) or be 100 pounds over with co-morbidities but Tricare is cloudy on their requirements. Talk to your Tricare specialist. They will be able to help you. Good luck.

[soooconfused 0]

thanks for the reply. May I ask if you are getting it done at a MTF? Or are you getting a refferel for civilian doc?

[Rsilversea 2]

Using a civilian doctor. I live in New Jersey and don't feel like traveling just to get banded.

[soooconfused 0]

hmmm guess I'll have to wait to ask my doc. I go to the hospital on post, and never have to deal with tricare ~ I've only ever had to deal one time with being referred off post, and even then I never had to deal with tricare. So im really curious how it works if you get banded AT the MTF as a tricare prime benificiary.

Thanks for your replies :confused:

[soooconfused 0]

sorry im bumping this..............was really hoping to get some more answers!!!!! :thumbup:

[kellyjoiii 19]

GIRL! Calm down.:thumbup: Ok, let me say this. I have tricare prime (my dh is active duty navy) and I am scheduled for surgery in 17 days. Unlike the other girl, I have to travel for the surgery but am going to a non network dr. You know what? Let me message you my "story" as I did this a little while ago today. YOU SHOULD qualify for the surgery. HBP is a co morbidity with tricare bmi requirement being 35-39 and usually you only need one of those. As for the amount, if no co morbidities...100lbs overweight, BMI 40. Let me know.

[kellyjoiii 19]

SOOOOooooConfused, check your message box here, I sent you a message :thumbup:

[soooconfused 0]

thank you! Going to check now :-)

[kellyjoiii 19]

Soooconfused, the wait is probably because you do not have to do tricare. The list is probably first come first served at the MTF. Right? If it is at a military facility, then tricare should not be involved. I say try to get referred out. Much easier. :thumbup:

[soooconfused 0]

thanks kellyjoii ~ I think part of my confusion was I am just now "getting" that a MTF can do the surgery, and its not under tricare, but that specific MTF............THEN also tricare covers the procedure.......which can occur at a different hospital. That makes a diff i suppose.