Adrea 0 Posted January 7, 2011 Hello everyone! I have spent many hours researching lap band and reading hundreds of posts and I have decided to go ahead and try to get approval for the surgery. I have been over weight since I was 5 years old and I am SOOO sick of it!! I have tried alli adkins weight watchers results sort and sweet 20lbs gone 30lbs back. Problem is I have tricare and I know I don;t meet there requirements my BMI is almost 40 but not quite I am not 100lbs overweight for my body type and I have no comorbs that they list, I am however very close to 100lbs overweight have Reflux, Chronic back pain and depression from being overweight terrible family history of just about every comorb, heart attack, stroke, diabetes, congestive heart failure, sleep apnea, colon cancer, arthritis. So hopefully all this will be enough to get approved, I am praying for a miracle! I did not enjoy my childhood because of my weight and I refuse to have the rest of my life run by my weight. I may need some help but I am motivated to get it off!!. I am open to any advise or suggestion! Share this post Link to post Share on other sites
Mariasha 3 Posted January 7, 2011 There are people here on the forums who have put on weight in order to qualify. Not getting in to the ethics of that, just letting you know it is an option. Additionally, the FDA will most likely soon be changing the qualifications for lapband from a BMI of 40 to 35. You may soon find yourself being eligible. Good luck! Share this post Link to post Share on other sites
Adrea 0 Posted January 7, 2011 There are people here on the forums who have put on weight in order to qualify. Not getting in to the ethics of that, just letting you know it is an option. Additionally, the FDA will most likely soon be changing the qualifications for lapband from a BMI of 40 to 35. You may soon find yourself being eligible. Good luck! Yeah since I have been home for the holidays I am pretty sure I have gained weight. I saw that FDA was considering approval for lower BMI hopefully insurance will follow Tricare seems strict but I have read of people on here not meeting tricares requirements and still getting approved so I am hoping I can be one of them. Share this post Link to post Share on other sites
Dave_NW 92 Posted January 7, 2011 Yeah since I have been home for the holidays I am pretty sure I have gained weight. I saw that FDA was considering approval for lower BMI hopefully insurance will follow Tricare seems strict but I have read of people on here not meeting tricares requirements and still getting approved so I am hoping I can be one of them. I think a lot depends on the surgeon, and how they present the info to Tricare for approval. I'm told Tricare is one of the easiest insurance companies to get approval from (mine took just three days.) As for being "strict," Tricare follows what Medicare says. If the code for approval is in the Medicare book, Tricare will follow it. Check with your surgeon to see how they deal with borderline patients. And when you get weighed in, wear heavy clothes and lead underwear. LOL! Good luck, Dave Share this post Link to post Share on other sites
Adrea 0 Posted January 7, 2011 I think a lot depends on the surgeon, and how they present the info to Tricare for approval. I'm told Tricare is one of the easiest insurance companies to get approval from (mine took just three days.) As for being "strict," Tricare follows what Medicare says. If the code for approval is in the Medicare book, Tricare will follow it. Check with your surgeon to see how they deal with borderline patients. And when you get weighed in, wear heavy clothes and lead underwear. LOL! Good luck, Dave LOL thanks where could I get some of those?Jk Well I have been talking to a girl on here with the same problems the same height as me but I am 30lbs heavier than her and tricare approved her so I have a little hope. I'm scared to ask my PCM fora referral though, I don't want him to say no:( Share this post Link to post Share on other sites