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tricare and gastic sleeve



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does Tricare cover gastric sleeve?

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no, they dont.

and here is how i know as i went to their website:

Bariatric Surgery

TRICARE will cost share any of the following open or laparoscopic bariatric surgical procedures:

  • Roux-en-Y gastric bypass
  • Vertical banded gastroplasty
  • Gastroplasty (stomach stapling)
  • Adjustable gastric banding (i.e., adjustable LAP-BAND®)

If you meet all of the following conditions:

  • You're at least 18 years old or you must provide documentation of completion of bone growth.
  • You were unsuccessful with non-surgical medical treatments for obesity. Your medical records must show your failed attempts.
    • Diet programs, such as Weight Watchers®* and Jenny Craig*, are acceptable methods of dietary management, as long as there are monthly clinical visits with your doctor and medical documentation of your participation and your progress throughout the course of the dietary program. *These programs are not covered by TRICARE.
    • Physician-supervised programs made-up of only weight-loss medication management, do not meet this requirement.

    [*]You have proof of one of the following:

    • A body-mass index greater than or equal to 40 kilograms per meter squared (kg/m2); or
    • A body-mass index of 35-39.9 kg/m2 with one clinically significant comorbidity, including but not limited to, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea, Pickwickian syndrome, hypertension, coronary artery disease, obesity-related cardiomyopathy, or pulmonary hypertension.

TRICARE does not cover the following services:

  • Office visits solely for the treatment of obesity
  • Non-surgical procedures for treatment of obesity
  • Nutrition and diet counseling
  • Biliopancreatic bypass (jejunoileal bypass, Scopinaro procedure)
  • Gastric bubble or balloon
  • Sleeve gastrectomy
  • Gastric wrapping/open gastric banding
  • Unlisted procedures

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Like CG said, no they don't. My surgeon said seeing as Tricare is a government funded insurance they always follow the same guidelines as Medicare. Medicare and Medicaid have recently added the sleeve to their list of wls surgeries covered and it's just a matter of time before Tricare add it too. My surgeon says he has Tricare patients just waiting for the sleeve to be approved, but he has no idea when that might be....btw Love my band!

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I am a tricare patient and just like everyone else said, No they dont, I looked into it prior to getting my band!

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Isn't vertical band the same as a sleeve

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*keep in mind, no matter what WLS one gets, the DS, the sleeve, the band, the bypass or plication (or band/plication) unless the person adheres to their new lifestyle, it wont work*

to me, just having the surgery is not the answer. you must want it bad enough to do whatever you have too (that means following how to use it properly). just my 4 cents.

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Isn't vertical band the same as a sleeve

No, the vertical band is not the same as the sleeve. See this site on vertical banding:

It's kind of a cross between banding and stapling.

I'm on ChampVA and they don't cover sleeve, either, even though Medicare does - takes time for Congress to make any changes to the plans (go figure!!). Lapband and bypass and VGB are the only options. I don't think they do the band with plication, either but I'm not sure.

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