Finally APPROVED by Tricare Prime!

[AZArmyWife36 0]

Hi! After three denials from Tricare Prime, I'M APPROVED!!! Tricare approved me by the new BMI requirements. I didn't meet the old requirements because I wasn't 100 lbs overweight. My BMI is 35 and I have hypertension. Best of luck to everyone!!!

[formykids2 4]

I am so glad you got approved!! I really hope the new rules are helpful for more people to be able to fight the battle of getting Lap band with insurance!

[Mimilou2004 13]

That is wonderful...I am very happy for you. You have been persistent and now that will pay off!!!

Mimi

[Melknor 0]

Did you have to go through the diet counseling with your PCM? I see that is now part of the new requirements, unless I read it wrong. I'm just getting started on my journey and met the requirements

[Melknor 0]

Did you have to go through the diet counseling with your PCM? I see that is now part of the new requirements, unless I read it wrong. I'm just getting started on my journey and met the requirements under the old BMI with no co-morbitiies and now they changed it. Ugh!

[MelindaH 3]

Hi! After three denials from Tricare Prime, I'M APPROVED!!! Tricare approved me by the new BMI requirements. I didn't meet the old requirements because I wasn't 100 lbs overweight. My BMI is 35 and I have hypertension. Best of luck to everyone!!!

Congratulations.....good for you for being persistent and standing your ground. I wish you all the best for your surgery and in your journey to good health. And, also, I try to say this to every military person I come across on the forum. Many thanks to you, your husband and family for serving our country. If I already said it, just consider the source--middle age gray haired female, lol.

Melinda

[carlak 59]

Hi I am battling tricare. Can you give me some advise

[☠carolinagirl☠ 18,721]

i have tricare prime, what stage are you in..

[carlak 59]

Carolina girl, Thanks! I have 3 insurances, Vantage thru my job, blue cross thru husband and then tricare prime. My first 2 insurances dont cover bariatrics at all. I called tricare and they have given me a run around from telling me to quit my other two insurances, which I didnt. Then they told me to see pcm (i havent been on base in years) but I did. PCM said I was good candidade but tricare denied me. my bmi is 36 but I have no co morbids. EVERYONE in my family has diabetes including my son grandparents etc...My dad died of diabetes at 45, I have had my gallbladder out due to "fatty liver disease" I have documented hiatal hernia by endoscopy ive had my left knee operated on 3 times and the next time will require replacement. I have been fat all my life and I am so excited. Tricare told me to write an appeal. One nigt while on this site I saw a beautiful appeal letter that a girl had used but now for the life of me I cant find it again. I need help.

[carlak 59]

Okay Vanders I need help. I have three insurances the first two do not cover bariatric surgery that my third try care. When I started the process I was told that the problem was because I have three insurances. I want blackband so bad that I canceled one of my insurances. Then I was told to send in medical evidence supporting The lap band which I did. I caught all my medical records plus documentation ive had three knee surgeries sent in a beautiful appeals package. Today I received A denial lettet It states in the denial that I did not have proof of physician my weigh inwith the commercial diet plan. I have been Weight Watchers for years. Now I don't know what to do. Should I go to the doctor every month and get weighed. I have done everything that Tricare has told me to do. Now I am considering getting a sleep study. Any advice is appreciated

[t2dav 17]

This is great news good luck to you!! I may need some advice battling my insurance company

[carlak 59]

Carolina girl I have been trying to reach you. I font know how to work this forum PLEASE email me bmxmomla@aol.com I am in TEARS over tricare