Tricare becoming United

[TheDuchess 106]

Hey all! Does anyone happen to work or be well knowledgable in the change over?

I received my approval to see the Surgeon and attend the seminiar. But in April Tricare changed to United. I was informed over the phone that as of February Triwest/tricare required 6 months of documentation with the Surgeon - that meant all who were priorly required to see a nutritionist had to start their 6 months over.

We are Air Guard, so we only have the insurance for as long as my husband is activated (October will be his end date). Does anyone know how things will change? Will I have to start over? And will they require the 6 months to start over too?

I was approved before and my insurance timed out. I've been praying so hard, my heart hurts at the thought that it's going to happen again.

[☠carolinagirl☠ 18,722]

(they also are known as united concordia) is that what you mean? i have tricare prime north and when i started my process, my surgeon advised me i had to do a 6 month wait..that wasnt the case and the tricare website nor the 800 told me that either. but that was my experience....if you have to do the 6 month, did you have a 1st month already?

[Puppypaws57 137]

I have Tricare West and I am interested in the changes too. I already have my lap band, but am curious about the changes.

I didn't have to do the 6 month diet.

[DianaDickey 3]

United Health care? If that is the case you can call them and ask a rep what they cover. I know it depends on your employer as to what kind of plan they pick. I worked directly with United Health care and would cry if I ever found out I had to use them. They were terrible with how often they changed things, but again it depends on what plan your employer chose.

Diana

[CHEZNOEL 4,061]

Most doctors offices have a staff person who is very knowledgeable about insurance. Call the office and ask to speak to them for your questions.

[TheDuchess 106]

The 6 month mandatory about seeing surgeon was passed this last Februrary.

United does lapbands, from what I've already seen.

I'm just wondering if there will be any hiccups, and if there are if they'll be in my favor! lol (like nixing the 6 month visits with the surgeon).

The seminiar is on April 4th, although I've been to one before they've said since it was 3 years ago I have to go again. I can't set up an appointment with the Surgeon until then - so no, I haven't already seen him and this won't count as month one.

[kazjim98 618]

From what I understand from the letter I received, if you have any referrals or authorizations that extend past March 31, 2013, United will contact you to let you know whether you need to get a new referral or authorization...this applies to me because I have a referral that starts in December of last year and ends in May of this year for 6 monthly visits for fills with my surgeon...As far as the 6 months of supervised diet goes, I did it and I was told that if it's a requirement there's no way around it....

[bgaddis 8]

I work for United Healthcare Military and Veterans.....don't worry about your coverage, I am TriCare Prime as well, UHC is taking the place of TriWest not TriCare. We will only be managing your care not changing anything. You do however need to do your 6 months of weight check-ins with your PCM. This isn't something new for UHC, I had to do it last year as well!! Good luck!!

Barb

OP...where do you live??

[TheDuchess 106]

I'm in Washington State - thanks for the info! I'm worried my time will be cut short as I have to wait until next month to attend the seminar and then I start to see the surgeon for my check ups. Our insurance will likely end in October when my husband's orders end. That's only 6 months as is :/ Is there ANYTHING I can do to speed up the process?

[bgaddis 8]

That would be up to your doctor. Have you started your 6 months of weight check-ins?? Do you have the option of buying tricare after his orders are done!?

[TheDuchess 106]

I don't know about buying Tri-care after he's done. I haven't started the 6 months of check ins because they said you have to go to the seminar first, and you have to see your SURGEON for the check ups, not just your PCP. People who were seeing their PCP or a nutritionist had to start their 6 months over completely when this went in to effect. It wouldn't be an issue if he was always active duty, but he's Air Guard, so things are difficult in all of this.

As of now I'm praying his orders will get extended, or I'll be able to have something come in my favor before October.

[Joryn 1]

Hello,

Did your doctor's office have any information? If it is denied they give reasons and what needs to be done. Prayerfully, you have a very proactive team who will leave no stone unturned. Have you called Tricare? If you email me the information I can ask my doctor's office if you'd like. I was denied initally and they eventually approved it. Just let me know.

[TheDuchess 106]

UPDATE:

I called prior to the seminar and had my appointment with the surgeon EARLY So I attended the seminar on Thurs and had my first consult with the surgeon today.

I was approved for the visits with the surgeon, 6 visits, and the ball is rolling! I do have to do the 6 months of consults, which is unfortunate, however, that should be done by August, giving a good month and a half to get the surgery.

Everything seems to be going great thus far! Thank the Lord!

[cflick 303]

Hey I know you said above you did not know if you had the ability to keep Tricare when he comes off of deployment...

My Hubby is in the National Guard we went through a deployment a couple years ago and have been on Tri Care ever since... when he came home he just had to switch out plan to TriCare Reserve... We can keep that till he leaves the Guard and at his rate he may never do that... been in 19+ yrs...

Congrats on getting your appts squared away! Good Luck!

[TheDuchess 106]

Oh?? Did you get the surgery while on Tricare Reserve? Thanks for the reply and well wishes :]