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Tricare Prime (West Region)



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I am located here in San Diego and my local MTF is Balboa. This is my story...my PCM is a civilian Dr. thru Scripps Clinic and I went to her on Sept 7th regarding the lap band so she submitted a referral to Tricare for me to see their surgeon who is also civilian for a consultation. Within a week Tricare Prime approved me to see the civilian surgeon for the consult. On October 23rd all my paperwork was submitted to Tricare for lap band surgery within 24 hrs I was approved with modifications. Meaning that I can have the procedure done but it has to be done at the MTF Balboa.

My issue is...why did Tricare approve me to see an civilian surgeon for the consult when they knew all along I would have to go to Balboa for the actual surgery. I am so frustrated because Balboa is short on surgeons I have to wait to Dec 6th before I can even see a surgeon for a consult and depending on who the surgeon is I might have to do all my testing and evals all over again. The only good thing that has come out of this is that I have had more time to research and think and now I have decided on the sleeve instead of the lap band...

Which brings me to my next issue...hopefully the surgeon that I will see on Dec 6th is authorized to do the sleeve if not I do not know how much longer I will have to wait because the other two surgeons are booked to who knows when and I do not think that Tricare Prime is approving the sleeve outside of the MTF yet.

If anyone has gone to Balboa or any MTF to have this done can you tell me what to expect and what testing did they require of you?

Thanks and Good Luck to All

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This doesn't directly relate to your question but I thought I would share my story to show support for your decision to go with the Sleeve.

I had the Lap Band in 2007 in Boston and had slow weight loss until I started having complications about 10 months ago and then the weight fell off. But I also couldn't keep anything down. During my second hospitalization for dehydration etc. the Band had completely slipped, so bad that I was in serious risk of the blood supply being cut off from my stomach and the organ dieing which would have resulted in my death. My Surgeon did emergency surgery to remove the Band and has refused to put in another one and with good reason. The Band is great when you don't have complications but it is not as permanent as they may lead you to believe. From the evidence that I have read surgeries to remove the band will surpass putting them in in the near future. I have three siblings that have had WLS surgery 2 with Bypass one with Sleeve. One Bypass sib is still 100+ overweight and the other overweight but is much healthier. The one that had the Sleeve has been much more successful and is living a healthy and productive life.

At this point in time Tricare in a civilian setting is not being covered. I'm hoping and praying by sometime next summer Tricare will cover but until then your best bet is at an MTF.

Good Luck and please keep us posted.

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HEY @PASHION IM STATIONED AT FORT IRWIN I HAVE TRICARE PRIME TOO (WEST) ARE THEY MAKING U DO,THE 6MONTH DIET PLAN? DID U GET SURGERY YET

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