Tricare Prime Gastric Sleeve Surgery Coverage Progress

[Anjelika 14]

Thank you so much for the info, calitrells! My husband is active duty and I have tricare standard. I will call the MTF tomorrow. *:-)

[Txsmama 22]

SAMMC (at Ft. Sam Houston in San Antonio) has a Bariatric Department, quite a few surgeons. They will do the sleeve here, as well as gastric bypass and a few Lap bands. I am fortunate that my hubby is stationed here. The last I heard wwas that Tricare doesn' t cover the sleeve, but you can get it done at an MTF. Good luck!

[Anjelika 14]

SAMMC (at Ft. Sam Houston in San Antonio) has a Bariatric Department, quite a few surgeons. They will do the sleeve here, as well as gastric bypass and a few Lap bands. I am fortunate that my hubby is stationed here. The last I heard wwas that Tricare doesn' t cover the sleeve, but you can get it done at an MTF. Good luck!

Thank you txsmama! I'm pretty sure that there's a program here at Tripler. I tried calling the operator there and he had no idea what I was talking about. He probably shouldn't be the one answering the phone. Lol

[kbbennett 0]

Ok, so I am new to this site. I got a Lap Band 5 years ago in Mexico. Surgery went well. I flew home and was back at work the next week. My first obstacle was finding somebody to do fills. Found a dr. that would do it, but charged me 300$ a fill. I am not made of money...I got about 5 fills over the next year. Slowly, but surely, the weight started coming off. I lost a total of 70 pounds. Then about a year and a half ago two things happened around the same time. One, I found out I had ovarian cysts and fibroids. They caused me no small amount of discomfort. Then, I got a sinus infection. I have horrible allergies and sinuses (part of living here in west TN)....Anyway, constant drainage of sinuses blocked my stoma...and for about a week I was SICK...couldn't get anything down.....Finally, I started feeling some better....but over the course of the next year, I mistook symptoms. I noticed (of course) that I was creeping back up the scale. I married a wonderful man in Nov. He is in the NG...and at this time he is active duty. I started having some serious pain in my left side...same side as my port...same side as the cysts...finally went to ob/gyn...she sent me for CT scan...yes, cysts were there....but so was infection around my port and tubing...Within a month, I had a open, draining wound over my port, and the port was actually visible. Finding a dr to take it out was a NIGHTMARE...but, finally, this past Tuesday, it was surgically removed. I am sooooo depressed. I don't know why, but taking it out was 10x worse than putting it in.

My husband is very supportive, bless his heart. During my convalescence, I discovered this site. Looks like I have three options. 1> can go to an MTF...I called one about an hour and half. Not the friendliest woman took my call. Wasn't very clear on what I should do.

2> go to Bariatric specialists and try to get Tricare to pay 3> go self pay if all else fails....

Where should I start? Any suggestions?

I prefer to have the sleeve done...but may have to end up with bypass...

[gingersnap 11]

Ok, so I am new to this site. I got a Lap Band 5 years ago in Mexico. Surgery went well. I flew home and was back at work the next week. My first obstacle was finding somebody to do fills. Found a dr. that would do it, but charged me 300$ a fill. I am not made of money...I got about 5 fills over the next year. Slowly, but surely, the weight started coming off. I lost a total of 70 pounds. Then about a year and a half ago two things happened around the same time. One, I found out I had ovarian cysts and fibroids. They caused me no small amount of discomfort. Then, I got a sinus infection. I have horrible allergies and sinuses (part of living here in west TN)....Anyway, constant drainage of sinuses blocked my stoma...and for about a week I was SICK...couldn't get anything down.....Finally, I started feeling some better....but over the course of the next year, I mistook symptoms. I noticed (of course) that I was creeping back up the scale. I married a wonderful man in Nov. He is in the NG...and at this time he is active duty. I started having some serious pain in my left side...same side as my port...same side as the cysts...finally went to ob/gyn...she sent me for CT scan...yes, cysts were there....but so was infection around my port and tubing...Within a month, I had a open, draining wound over my port, and the port was actually visible. Finding a dr to take it out was a NIGHTMARE...but, finally, this past Tuesday, it was surgically removed. I am sooooo depressed. I don't know why, but taking it out was 10x worse than putting it in.

My husband is very supportive, bless his heart. During my convalescence, I discovered this site. Looks like I have three options. 1> can go to an MTF...I called one about an hour and half. Not the friendliest woman took my call. Wasn't very clear on what I should do.

2> go to Bariatric specialists and try to get Tricare to pay 3> go self pay if all else fails....

Where should I start? Any suggestions?

I prefer to have the sleeve done...but may have to end up with bypass...

Loosing the LapBand is no small thing, it has been apart of your body for over the past 5 years. It has been there to lean on and it was just taken away so yes it is normal to miss it.

I had my band removed last September and I just wasn't ready to loose my tool but was very ready to get rid of the problems it caused. I couldn't imagine the struggle you had dealing with actually being able to see the port...sounds so painful!

I think first you need decide if you want another LapBand, switch to VSG, have the RNY, or do it on your own. Personally, through my experience the LapBand is a poor option, way to many complications. And I can't seem to do it on my own so I'm on a Quest to get the VSG. LapBand and RNY are both covered under Tricare Prime. However, VSG is ONLY covered at a Military Treatment Facility.

So once you make your decision consult with your PCM and get a referral. If you decide to get the VSG then you will need to locate an MTF that does the surgery and have your PCM refer you to the clinic. On the Tricare Website there is a list of MTF's and the main phone numbers. Call and ask for general surgery at each MTF local to you until you find one that does it and that you are happy with. This forum is a really great resource to find where others have had their surgery.

So where are you currently stationed? Are you indeed wanting the VSG or still deciding? Please keep us posted.

[kbbennett 0]

My husband is active duty NG now, so we aren't stationed per se anywhere. We live in west TN...half way between Memphis and Nashville. The MTF I called the other day (after reading your posts on here) was Ft. Campbell, which is in KY technically...but in the city of Clarksville, which in in TN. About 1.5 hours from here. My brother in law is actually stationed there. The lady that answered the phone said they don't do sleeves, only bands and bypass. And, I will not have another band. I prefer the sleeve.

But, I am also new to the military...we have been married six months. I can only go the MTF while he is active duty, correct?

[kbbennett 0]

Loosing the LapBand is no small thing, it has been apart of your body for over the past 5 years. It has been there to lean on and it was just taken away so yes it is normal to miss it.

I had my band removed last September and I just wasn't ready to loose my tool but was very ready to get rid of the problems it caused. I couldn't imagine the struggle you had dealing with actually being able to see the port...sounds so painful!

I think first you need decide if you want another LapBand, switch to VSG, have the RNY, or do it on your own. Personally, through my experience the LapBand is a poor option, way to many complications. And I can't seem to do it on my own so I'm on a Quest to get the VSG. LapBand and RNY are both covered under Tricare Prime. However, VSG is ONLY covered at a Military Treatment Facility.

So once you make your decision consult with your PCM and get a referral. If you decide to get the VSG then you will need to locate an MTF that does the surgery and have your PCM refer you to the clinic. On the Tricare Website there is a list of MTF's and the main phone numbers. Call and ask for general surgery at each MTF local to you until you find one that does it and that you are happy with. This forum is a really great resource to find where others have had their surgery.

So where are you currently stationed? Are you indeed wanting the VSG or still deciding? Please keep us posted.

You will see...I am very new at this...not sure if I am supposed to quote or post...LOL...I know how to look stuff up..but interacting is new...I made a post and a quote LOL

I would be willing to travel, I think...If my husband would be good with it...If I could get this done during the summer months, that would be great. But would I have to go to seminars and all that?

[gingersnap 11]

You will see...I am very new at this...not sure if I am supposed to quote or post...LOL...I know how to look stuff up..but interacting is new...I made a post and a quote LOL

I would be willing to travel, I think...If my husband would be good with it...If I could get this done during the summer months, that would be great. But would I have to go to seminars and all that?

kbbenett

I started out looking for the biggest programs and didn't start local. What I found was that the further away you are the less likely they will be to take you on as a patient. They are concerned about having access to pre and post op care. I also found that each program wants you to play by their rules and go through their program just like you were a WLS virgin....very frustrating I know. But if you want the surgery it's a game you have to play. The only way you can get through the program quicker is if you have a LapBand that needs removed ASAP then they seem a little more willing to work with you. But most people have theirs removed through a civilian clinic.

I'm starting over fresh at Fort Gordon. I'll need psy, nut, endoscopy, bloodwork, info session, support group etc. all at Fort Gordon and it's a 3hour drive. I think it will take anywhere from 3-6months to get a surgery date. But the good news is that your local Tricare Rep may be able to reimburse for travel if you go over 99miles away.

[kbbennett 0]

Well, all of this is good ole common sense....just helps to have somebody who has been through it all and understands...thanks for the support

[gingersnap 11]

Good Luck...I have no idea about how it works with NG and if your insurance changes or not? Also, take a look at Obesity Help Forum I've found a few military people on their as well!

[kbbennett 0]

Good Luck...I have no idea about how it works with NG and if your insurance changes or not? Also, take a look at Obesity Help Forum I've found a few military people on their as well!

Hey, I am trying to figure out by reading...getting conflicting passages...Medicare approved VSG?? state by state basis....what does that mean for Tricare coverage???