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the dr called tosay and said tricare came back and said they would only pay for 50 percent of the surgery anyone ever hear of this?

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Read my sad story about tricare

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the dr called tosay and said tricare came back and said they would only pay for 50 percent of the surgery anyone ever hear of this?

no. i havent. i have had tricare prime for 7 yeas now

i have tricare prime and they paid all but 183 dollars

if a dr refers you, you meet the qualifications, complete pre ops, dr submits for approval....

then tricare will pay for it by approving or not approving it.

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If I just had Tricare it'd be no prob but since I gave 2 other ins that don't cover it then Tricare won't although I meet all criteria

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Hello, I'm new to this and any information would be gratefully appreciated. I am about to be 52 and have been overweight since my last son was born...21 years ago! I am 5'5" my weight floats between 195-203. While we were stationed in Alaska I asked my PCM for help with the lap band and she laughed at me, said I wouldn't qualify. Yet, I would see younger women, who weighed a little more than me that were going in for gastric bypass.

If you have any tips that I might could use to convince my PCM, here in Missouri, to get me a referral that would be great.

Thanks ~ Connie ~

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Feels defeated

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Thats weird!! I had my surgery June of last year and Tricare paid all except 25 dollars! I wouldn't think it mattered even though it's Triwest!

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Hello' date=' I'm new to this and any information would be gratefully appreciated. I am about to be 52 and have been overweight since my last son was born...21 years ago! I am 5'5" my weight floats between 195-203. While we were stationed in Alaska I asked my PCM for help with the lap band and she laughed at me, said I wouldn't qualify. Yet, I would see younger women, who weighed a little more than me that were going in for gastric bypass.

If you have any tips that I might could use to convince my PCM, here in Missouri, to get me a referral that would be great.

Thanks ~ Connie ~[/quote']

Connie, are you at Whiteman AFB???

Barb

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Hello Barb, no we are at Fort Leonard Wood...aka Fort Lost in the Woods.

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I had my surgery July 09 and tricare paid 100%. Im in Alaska and my doc is awesome. I'm 5'4" and was 252 lbs and lost 10 before surgery. I didn't qualify at first cause I was 239 lbs. I know it's sad but I gained 13 lbs to qualify. I did have high blood pressure at that time also

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I have Tri Care Prime and they paid 100% of my surgery at Fort Sill, Oklahoma, in January. I am 5'6" and weighed 244, I did however have high blood pressure and was on medication for it, also it was a good year before I was able to have surgery due to all the appointments (sleep study, EKG, nutrition, psychiatrist, lab work) the whole process was completely worth it!

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I have tricare prime europe region. I was banded May 23 of this year. Insurance covered it 100%. My doctor put in a referal and a letter of medical nessity. I had seen a nutrionist once and within two weeks of talking to my doctor about lapband I was approved. I tell you this because alot of people are told they have to fo six month seeing a nutrionist before insurance approves it with tri-care but that it not a requirement. I barely even met bmi requirements the day of wiegh ins infact the day of surgery I was actually under bmi requirements and I still was 100% covered. I did however had several co-morbidity. I had weight induced athma, acid reflux and a couple other things. The first time my doctor put in the referal she did not put in the medical nessity letter and tricare told me they needed that all I had to do was call my doctor and ask that she submit that and as soon as that was submitted I was approved within 5 days. You may want to find out if your doctor submitted that because without that its really hard to get approved with tricare

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I also never had to do a sleepstudy, ekg or any of that other stuff to be aproved

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