Anyone........willing to share TRICARE appeal letters

[Nume31 1]

Hey ALL

Well this process is DRIVING ME NUTS! I have 2 insurances...one pays the other does not....Doc MUST bill one for denial before other will pay. Tricare is 2nd to employer insurance

I am 100lbs overweight....however I don't have any co-mobilites ( blessed)...and I am feeling like this might be a sticky problem for me.

Is there anyone who has written an Appeal letter to Tricare that was successful in getting approval and will to share : )

I am preparing " is case" this becomes a small issue for me : ) also any advice would be helpful as well!

Thank you in advance!

[Mimilou2004 13]

You will not win an appeal,,,the standards are followed strictly. Sorry.

[Rsilversea 2]

I won my appeal with Tricare. I had to have my Tricare rep duke it out with the case worker though because I was also 100 pounds overweight with no comorbidities. Apparently they were interpreting their own rules wrong. Tricare has since changed it's rules. Don't worry about a denial yet. If it does happen, find out why they are denying it and have your local Tricare rep and doctor help you with an appeal.

[Nume31 1]

Wow really....thanks for NOT being supportive! I have read several posts that were similar to mine and they appealed and got an APPROVAL. Trying being more supportive when you reply to a post......

You will not win an appeal,,,the standards are followed strictly. Sorry.

[Nume31 1]

Thank YOU! I will wait it out and see...I am bitting my nails just waiting for a response...I will keep you posted

I won my appeal with Tricare. I had to have my Tricare rep duke it out with the case worker though because I was also 100 pounds overweight with no comorbidities. Apparently they were interpreting their own rules wrong. Tricare has since changed it's rules. Don't worry about a denial yet. If it does happen, find out why they are denying it and have your local Tricare rep and doctor help you with an appeal.

[Mimilou2004 13]

Wow really....thanks for NOT being supportive! I have read several posts that were similar to mine and they appealed and got an APPROVAL. Trying being more supportive when you reply to a post......

[Mimilou2004 13]

Wow really....thanks for NOT being supportive! I have read several posts that were similar to mine and they appealed and got an APPROVAL. Trying being more supportive when you reply to a post......

I will post what I know....supportive pap or not...I have NEVER heard of anyone winning an appeal in my area without a co-morbidity showing up. I actually hope you win, even though you are a snotty acting poster. Stick around a few years and learn something.

[Rsilversea 2]

Usually I ignore crap like this since it's not worth my time but I have to agree with the OP. You may not have meant to sound like it but it came across as "snotty". And so did your reply. I'm sure you know people who have not won appeals but there was a better way of putting it than "You won't win." As I stated, I did and so have many others on this site. "Stick around a few years and learn something." That there are snotty posters out there? I'm sure if the OP has read this board then she knows that there nasty people out there. Nume, keep your chin up and don't fret. As I said, you haven't been denied yet. If it happens, your doc and your rep will be able to help you out.