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Tricare Prime North



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they approved me to have surgery. the clinic just told me today.

((thank you to everyone who offered me support)) :rolleyes:

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I'm so excited for you! I'm still waiting on Tricare north for a answer;) it seems like it is taking forever. I'm starting to worry:( but keep us informed

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Are you active duty Tricare?

Congrats!

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Ok, my hubby is retired army. When I got my EOB, I was told that I only had to pay co-pay. A few days ago, I got a letter in the mail from Tricare saying that I owe my provider $4,308 .. Wondering if this is an oversight or if I was given wrong information when I scheduled the surgery.

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yvonne74 you have to really stay on top of tricare! they don't like me because i worked in medical insurance for several years and i've called them on several of their mistakes. i had a major surgery a couple years ago and they asked for some info from me that was not needed at all. it took me months going round and round with them for them to finally pay. i hope you can get everything straightened out with them. also, did you ever speak with anyone regarding your benefits for surgery? if so, and they quoted you on a certain amount that they arent honoring you may be able to get that call retrieved. when i worked for bcbs they paid many claims that the reps had misquoted. one girl nearly got fired for incorrectly quoting a bariatric surgery as being covered at 100% of the allowed amount. turns out that person did not even have bariatric coverage on her policy but because she was quoted those benefits bcbs had to pay the bill. good luck to you!

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Yvonne74, I have Tricare Prime North and my husband is Retired Navy. I had to do alot of the work and checking up on Tricare at first, because they can be really slow at times, but they paid for all but $50 at the time of my surgery. And my fills are a $12 co-pay. I would check with them again and find out why they are asking you to pay that much, unless they have you in as not approved by mistake. I was only approved because I had more than 2 co-morbilities causing health problems otherwise they would not have covered me, because I did not meet the 100# over weight status. Hope you get the answers you need.

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hi Army mom just a $12 co pay on fills? i was wondering about that. my clinic said i would only need to pay 184 for my surgery and they pay the rest so i am thankful.

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Thanks ladies! My fills are $12 co-pay. I was told that I only had my $35 co-pay for the surgery. That is what I paid.. So far, I haven't gotten another "bill" or anything so maybe it has been taken care of? I do think my surgeon over charged Tricare. They billed tricare over $82,000 for the surgery!! Thats a lot for a surgery if you ask me!

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    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

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        That sounds awesome. I'll have to check that out thanks!

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