Dave_NW 92 Posted March 18, 2011 did anyone with tricare have to do six months of dieting? Tricare does not have a six month diet requirement. Go to the Triwest website and search the database for the exact wording of what they will and won't pay for. Having said that, your surgeon may have a requirement. You'd need to ask them about it if it concerns you. Dave Share this post Link to post Share on other sites
LaToya 0 Posted March 18, 2011 Thanks Dave. I spoke with Coordinator and she says it is a Tricare rule. Tricare says it isn't. I am not getting a good feeling about this place. I will talk to the doctor on the 28th and see what he says. Tricare even told me to find a new doctor if they don't at least submit it. Could just be the coordinator didn't know what she was talking about. Thanks again! Tricare does not have a six month diet requirement. Go to the Triwest website and search the database for the exact wording of what they will and won't pay for. Having said that, your surgeon may have a requirement. You'd need to ask them about it if it concerns you. Dave Share this post Link to post Share on other sites
Dave_NW 92 Posted March 19, 2011 Thanks Dave. I spoke with Coordinator and she says it is a Tricare rule. Tricare says it isn't. I am not getting a good feeling about this place. I will talk to the doctor on the 28th and see what he says. Tricare even told me to find a new doctor if they don't at least submit it. Could just be the coordinator didn't know what she was talking about. Thanks again! Insurance Coordinators are supposed to be on top of the regulations. If this person isn't up to date, you definitely should bring it to the attention of someone who can change that. My experience with Tricare was that they are very specific about what they require, and what they will approve. In my case, it ws three days between date of submission, and when I was approved for surgery. No six month diet required. If other thngs aren't stacking up, don't hesitate to move to a different clinic. You need to have confidence in your surgeon's team. Good luck! Dave Share this post Link to post Share on other sites
crafty mama 0 Posted July 1, 2011 how do you figure out the 200% rule? Share this post Link to post Share on other sites
YngGram 73 Posted July 2, 2011 how do you figure out the 200% rule? My guess is Small framed--being able to get your hand around your wrist (I think) 100 lbs. is your ideal weight and you weigh 300 I had the comorbs so I fell into the 100 lbs. over group.. Share this post Link to post Share on other sites