Military Hospitals and VSG

[Disney 20]

Can anyone who has had their VSG done at an MTF please let me know where it was done and if you were from out of state, and also how your experience was?

I am having a hard time finding an MTF near me and when I found one kinda close, but still out of state, they said they could not take out of state patients.

I would like to hear any input anyone has on this. I would also like to thank Tiffykins for helping me so much.

I just don't think I will ever be able to afford to self-pay and am getting discouraged.

Thanks everyone!!

[Dawn 16]

I had mine done at the MTF here at West Point. My DH is reitred Army and we live about 14 miles outside West Point and I've had everything done there! I don't know about going out of state thing as usually you are "tied" to a certain MTF and you would have to transfer everything over to a new MTF in order to then use it unless in case of an emergency.

Where are you at?

Good Luck!

[Disney 20]

I had mine done at the MTF here at West Point. My DH is reitred Army and we live about 14 miles outside West Point and I've had everything done there! I don't know about going out of state thing as usually you are "tied" to a certain MTF and you would have to transfer everything over to a new MTF in order to then use it unless in case of an emergency.

Where are you at?

Good Luck!

Thanks for the reply! I am in Mississippi and DH is retired Army also, but we don't use an MTF, not even one close, so we use Civilian Dr's. So actually, I don't guess I would have to transfer anything, just my med. records from my PCM. I just don't know. It is getting more and more frustrating. I just cringe at the thought of self pay when it would cost me ZERO at an MTF.

Thanks again~

[Dawn 16]

Have you checked into other branches MTFs? I know Kessler is in MI, don't know if they have an MTF or not but thought I would throw it out! Have you talked to Tricare about if you can get it done at an MTF close by?

[Disney 20]

Have you checked into other branches MTFs? I know Kessler is in MI, don't know if they have an MTF or not but thought I would throw it out! Have you talked to Tricare about if you can get it done at an MTF close by?

That's just it, there are no MTFs nearby. The closest one I have even found that does VSG won't accept me because I am too far away.

[myrori 55]

My Daughter is military and she was referred out to a doctor in St Louis MO about 3 hours from her in Missouri. They don't have any big military hospitals there.

[Tiffykins 673]

Have you checked out the VAs in your area? I just thought of this, and know a couple of people that had VSG with Tricare for Life (retired Tricare recipients) at VA hospitals.

Don't get tricked into thinking Tricare will pay for VSG via a civilian or you'll get a big nasty bill when they deny all the charges since it's not an approved covered procedure outside of MTFs and VA hospitals.

Many of my friends have jumped through hoops via civilians that swore it'd be covered, then it was denied, one even got the surgery, and now she's trying to get a congressional complaint together since she just received a nice little 41K bill from the surgeon and hospital for her surgery and 1 night hospital stay ! ! !

[Disney 20]

My Daughter is military and she was referred out to a doctor in St Louis MO about 3 hours from her in Missouri. They don't have any big military hospitals there.

Was this Dr in St louis at a military hospital?

If so, could you tell me which one it was?> I know there is a VA hospital there, but not sure about anything else.

[Disney 20]

Have you checked out the VAs in your area? I just thought of this, and know a couple of people that had VSG with Tricare for Life (retired Tricare recipients) at VA hospitals.

Don't get tricked into thinking Tricare will pay for VSG via a civilian or you'll get a big nasty bill when they deny all the charges since it's not an approved covered procedure outside of MTFs and VA hospitals.

Many of my friends have jumped through hoops via civilians that swore it'd be covered, then it was denied, one even got the surgery, and now she's trying to get a congressional complaint together since she just received a nice little 41K bill from the surgeon and hospital for her surgery and 1 night hospital stay ! ! !

That is such a good idea. But I have not heard the best stories about VA hospitals! Maybe it is different nowadays.

Believe me, I don't expect Tricare to pay for anything! They have made it LOUD and CLEAR that they won't touch a claim for VSG.

WOW, I don't even know what I would do if I got a bill that large! I guess if they wouldn't adjust it with the congressional complaint like you mentioned, they would be getting $25 a month for the rest of my life!

and anyway, what in the world made her bill so freakin high? All the quotes I have seen were around the 12-15 thousand mark. Labs, etc included.

[Dawn 16]

OMG That is crazy amount!!! I will say that being on Tricare as a retiree I was charged an Admin fee that I didn't know I would be. It was only $50 for my whole hospital day (3 nights)! We are Tricare Prime so I didn't think I would be charged anything as I thought it was going to be the exact same as when we were AD but oh well, I'll take $50 over anything else anyday!!

[Tiffykins 673]

That is such a good idea. But I have not heard the best stories about VA hospitals! Maybe it is different nowadays.

Believe me, I don't expect Tricare to pay for anything! They have made it LOUD and CLEAR that they won't touch a claim for VSG.

WOW, I don't even know what I would do if I got a bill that large! I guess if they wouldn't adjust it with the congressional complaint like you mentioned, they would be getting $25 a month for the rest of my life!

and anyway, what in the world made her bill so freakin high? All the quotes I have seen were around the 12-15 thousand mark. Labs, etc included.

Ohhh my band surgery with 2 days in the hospital was 42K and that was in Pensacola. There are so many fees that hospitals throw in that are completely withdrawn for self-pay patients. The 42K is what my insurance paid, they actually billed closer to 54K but after negotiated rates, and some fee negotiations with the surgeon it was decreased. My band surgeon billed Tricare nearly $300 for a fill and was paid $150, for a fill under fluoro, add on radiology fees for the fluoro machine and the hospital fee for that was $400 bucks.

[myrori 55]

Was this Dr in St louis at a military hospital?

If so, could you tell me which one it was?> I know there is a VA hospital there, but not sure about anything else.

I am sorry, she was actually referred to Columbia Mo and it was a civilian hospital. She has Tri Care West and they paid the bill 100% for her bypass.

[Disney 20]

I am sorry, she was actually referred to Columbia Mo and it was a civilian hospital. She has Tri Care West and they paid the bill 100% for her bypass.

Ohh, ok gotcha! My tricare south will pay 100% for bypass and lapband, but I want the sleeve or nothing. My mother thinks I have lost my mind, but you just can't really understand the logic behind it till you do the research. My mother had the band and has had NOTHING but trouble. She is in pain everyday just from eating a teeny amount and they just tell her, basically, that's life. She has lost a lot, but at what price? Pain everytime she eats? But she can't see paying for something out of pocket when my insurance pays those others completely.

I am hoping tricare will start covering VSG the first part of 2011, but if they do not, I am going to scrounge up the money however I can.

Thanks for the reply!

[myrori 55]

Ohh, ok gotcha! My tricare south will pay 100% for bypass and lapband, but I want the sleeve or nothing. My mother thinks I have lost my mind, but you just can't really understand the logic behind it till you do the research. My mother had the band and has had NOTHING but trouble. She is in pain everyday just from eating a teeny amount and they just tell her, basically, that's life. She has lost a lot, but at what price? Pain everytime she eats? But she can't see paying for something out of pocket when my insurance pays those others completely.

I am hoping tricare will start covering VSG the first part of 2011, but if they do not, I am going to scrounge up the money however I can.

Thanks for the reply!

I hope so also. Perhaps when they see other insurance companies jumping on board as they are they will start covering it. Does Tri care have an appeal process??? Maybe you could show how all the other private insurances are covering it now and the latest study that it is effective?

Best luck to you.

[pcos_chick 23]

I am set to get the sleeve at Portsmouth Naval Hospital but I live in DC. The DC area program was full and not accepting any patients so they were referring people out in town. Since VSG isn't covered that way I started calling other MTFs to find one that would accept me. NMCP is out of state for me and about 4 hours away....

Who told you they wouldn't accept out of state patients? Was it the general surgeon office or program coordinator?