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TriCare Prime & LapBand Procedure.


Tori Leigh
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How should I go about beginning this process? I feel awkward going on post (Fort Lewis, WA) and having a bunch of Army guys/girls judging me. I know there are civilian options, I just wanna know how to start this whole shbang. Thank you all in advance.

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If you have Tricare prime, just go see your PCM and let them know you're interested in surgery. You will need an authorization to see the surgeon. Don't let your pride get in the way; it's not as bad as you think. I also have Prime and the whole process from referral to approval only took 8 days. As we don't have surgeons here on our base (Malmstrom AFB) I'm seeing a civilian surgeon, and Prime is covering everything 100%. Just make sure to get all your paperwork squared away, and good luck!

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I just went to my PCM and told him I wanted a referral for Lap-band. It's all been a very easy process as far as insurance goes.

Here is my time-line-

http://imwiththeband7.blogspot.com/p/my-band-timeline.html

How should I go about beginning this process? I feel awkward going on post (Fort Lewis, WA) and having a bunch of Army guys/girls judging me. I know there are civilian options, I just wanna know how to start this whole shbang. Thank you all in advance.

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Tori, it's as others have said - start with a referral from your PCM, and the rest falls directly into place. Just be sure your referral is to a Tricare-approved surgeon/clinic that is authorized to perform the surgery. I also live in Washington, and I have Tricare Prime. I just went through all this. I was referred to two different Tricare-approved places first, only to learn they don't/can't do the surgery. On the third go-round, I was finally referred to the right place, and everything was smooth sailing after that.

If you're close to Ft. Lewis, they can do the surgery for you right at Madigan. They have surgeons on staff, and a very active bariatric program there. There are many others in your same shoes, so nobody will be judging you. In addition to lap band, they also do both RNY bypass AND the vertical sleeve gastrectomy, if either of those is a better option for you. I believe Madigan is the only place in Washington where you can get a sleeve surgery that Tricare will pay for. (I initially wanted to have that surgery, but found I could only get it at Madigan, which wouldn't work out for me. Banding was my second surgery choice.)

If Madigan isn't an option for you, Swedish Hospital in Seattle is the next closest, I believe. (There may be others.) That's where I had my band surgery. Awesome program, excellent surgeons, great staff. They combine many appointments on the same day, which shortens the time from initial intake appointment to surgery approval. In my case it was about three weeks till I was approved by Tricare for surgery.

Good luck with your journey!

Dave

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How should I go about beginning this process? I feel awkward going on post (Fort Lewis, WA) and having a bunch of Army guys/girls judging me. I know there are civilian options, I just wanna know how to start this whole shbang. Thank you all in advance.

Tori, take advantage of one of the few benefits we get from the military! We get these services free!!! I talked with my PCM about the procedure and she knew of the surgeon who did them. I am not near a military installation and am on prime remote. I had to do months of legwork to get it approved with this surgeon. Tricare kept referring me to gen. surgeons who could not due the procedure. I was persistent with many phone calls and finally got the results I wanted. I had my lap band put on this past Monday. Don't worry what those Army peeps think of you...this is for YOU! And is usually takes most people 6 months to get through the hoops of insurance but it only took me 2 months of appt's and my procedure was completed...so that part with tricare was easy...no 6 month waiting period or psych eval were needed. Good luck!

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I don't live near base anymore, so I use a civilian PCM. He put the referral in April 22nd, Tricare approved it May 14th. I spoke with my surgeons office, and the went ahead and put in the request for the procedure and Tricare approved in on May 19th. So it took about a month to get everything approved. I had the surgery July 13th, and am SO glad I did.

Don't worry about being judged. It's not about anyone but you. If you're ready to take this step, forget everyone else.

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