Wondering about Tricare Prime Process - how to begin?

[Mozzy 0]

Hi - I am just investigating having lap band surgery. Tricare Prime is our only insurer, and we live in the Military DIstrict of Washington. I have high blood pressure, hypothyroidism, and a BMI right around 40. Has anyone gone through the process? I suppose it starts with a visit to my PCM, right? What else is required through Tricare Prime for approval? Thanks in advance for any help.

[lorabeth 10]

I am tricare prime remote (we live in Alaska). My PCM sent me to the lap band doctor. I had to show 6 months of trying to lose weight on my own (I had all my weight watchers weigh ins, on the card and online), a nutritional consult, and a psych visit. My BMI was 38 and I have diabetes. It was a long process because I did everything then decided I would wait. Then almost a year later I decided to go for it. It took less then a month to decide and have a surgery date scheduled.

[☠carolinagirl☠ 18,721]

once i found a dr who accepted my tricare, my pcd referred me to tricare.....tricare approved visit and i had to fulfill all sorts of pre ops (had to again have pcd refer to tricare to approve all of this)...and then have the lap and dr submit for approval...i was approved within 48 hrs.

the tricare website offers you the criteria that has to be met but i think each case could be different

i was a 62 bmi and 150+ pounds overweight..i started in mid of feb..surgery beginning of june 2012.