Tricare(west) And Lap Band Surgery

[Sydnii 0]

Hello everyone!(:

I'm new to this website, but i've read loads of peoples stories and i find all of them helpful and/or inspiring!!(: I've been doing research on lapband for a while, and it's something i really want to get, i just attended a seminar this past tuesday. (first steps! yaaay! ) I have tricare prime and i wanted to know what you all think my chances of getting approved are?!

I'm 18, I have a BMI of 42, i've been overweight since i was five, i have gallstones and i have to get my GB removed, i have other minor problems due to my weight also, I've tried multiple diets, and my doctor even sent me to a dietician for a while.

Please let me know what you think my chances are, i'd be really greatful!

Thank you!

I hope everyone has A VERY MERRY CHRISTMAS AND A HAPPY NEW YEAR!!<3

[bluetigereyes 95]

I work in a hospital billing dept. I have seen tricare approve the procedure, but make sure you have everything in order when the auth is submitted. Don't give up hope. I just got my band on Thursday dec 22nd. I researched for 3years, and I'm so glad I did it.

[cutecamille 2]

I have Tricare Standard. I was denied at first because I did not show that my previous weight loss attempts were supervised by a doctor. Some insurance companies make you spend 6 months under a doctor's supervision. Tricare manual does not specify a length of time. Once I submitted that information I was approved. My supervised "diet" was not within two years and I know some insurances will only accept it if its within a few years of the surgery date. So for Tricare I submitted a provider referral, a letter from my pcp stating that I was not a drug abuser or user, a letter stating my body frame type (large, medium, small), proof of supervised weight loss (along with your weight for those supervised months), and of course high BMI. You do not have co-morbidities if your BMI is in the 40's, but if you have co-morb then your BMI can be in the high 30's. I was banded on Dec22. I do not have sleep apnea, my blood pressure fluctuates, i have asthma and gerd. The tricare manual can be found online. I am in tricare south. Good luck!

[USMC Wife 1]

I am TriCare Prime and had the procedure on January 27, 2011. Currently I am down 100lbs. TriCare is one of the EASIEST insurance carries out there to cover the surgery. As long as you meet their requirements they will approve you. There is no 6 or 3 month diet plan first. I had my consult on Dec. 23 and Surgery on Jan 27. That was the first date the Dr. had to do the surgery. I was able to get my phsych visit done, bloodwork, ultrasounds and x-rays all in time. Message me if you have any questions. Plus my doctor only does fills at the hospital under fluro and tricare has always approved those procedures within 2 days. Good luck on your journey!

[bullock512 0]

I am an Army wife and also have Tricare Prime (North). I am 27 years old and have type 2 diabetes. I am 5'2" and my starting weight was 228lbs. I asked my PCM for a referral and was approved on the first go around. You should be okay just make sure to cross all your t's and dot all your i's. You know how the military can be at times, LOL. Good luck!