Tricare Prime-- Not overweight long enough?

[USMC Wife 1]

It was actually the hospital that charged so much. My doctor charged a very minimal fee. Unfortunatly it is pretty common for places to bill insurance compaines large amounts. Some pay more than others. Tricare just happens to be on the low end of the payment scale. A long as the bill is paid and nothing came out of my pocket I am happy!

I am also on Tricare Prime-Remote. I had to have a psychological exam, a BMI of 40 or greater, and I had comorbidities. The doctor submited my paperwork on Friday and by Tuesday I was cleared for the surgery! I didn't have to show a history, do a diet or work out program. I was surprised at how little Tricare required compared to the other insurance companies. I guess that they figure that the health issues that would have outweigh the cost of surgery. I can't imagine them charging 47,000 for the surgery when the average is 16,000 to 20,000. Sounds like a doctor's office trying to rip off the insurance company.

[Dave_NW 92]

I can't imagine them charging 47,000 for the surgery when the average is 16,000 to 20,000. Sounds like a doctor's office trying to rip off the insurance company.

When my hospital billed Tricare for my surgery, which included repairing a ventral hernia and a hiatal hernia during the surgery, the total was more than $74,000. I about fell out of my chair when I saw that. But I monitored the Tricare website, and eventually saw that Tricare only paid them about $12,000. There's a reason to make very sure the hospital takes Tricare insurance before having this surgery - Nobody wants to pay the unpaid difference!

In my case, my total out of pocket costs, including the hospital stay and office visit copays, has been only about $100. That's a far cry from the $74K originally billed. Have I mentioned I like having Tricare Prime as my insurance?

Dave

[jenn79co 13]

Tricare prime is the BOMB! The process was easy and smooth.

When I first talked to my pcm about lap band, he told me he didnt think I would get approved........1 month later I had my surgery date!

It's been a year and a half and I have lost 80 pounds. (i was a slacker for the first few months)

doc billed tricare $33,000 and tricare paid $6,000. Tricare has also taken care of the adjustments (fills).

Total out of pocket for me was $50 for pysc eval, and $100 for protien shakes stuff the surgeon had me do preband. Money well spent!

Good luck!