Tricare Retiree Beneficiary Vs. Sleeve Gastrectomy

[samakar1516 1]

Hello everyone....

Sorry I've been away for a while....I've been trying to work out this Tricare thing, and in the middle of it my husband came home (he's currently working overseas in Africa), so I've had my plate full.

Well, good news! The clerk at the bariatric clinic in the MTF got me into the program...so I'm in !

I've already been to one support group, as well as orientation this past Friday. I will say that it all sounded a bit scary, but I'm sure it's not as bad as it sounds.

If anyone else has had any progress please let me know!

Take care....

[marinewife 0]

I know this comes several months later. Tricare is going to start covering the Sleeve as of March 5th, 2013 . It's about time !

[Elissa55 8]

I know this comes several months later. Tricare is going to start covering the Sleeve as of March 5th' date=' 2013 . It's about time ![/quote']

Hey marine wife, where do you see this info?

[marinewife 0]

My surgeons office told me . The lady that's in charge of sending everything to insurance and getting patients approved gave me the date 3/5 . I'll let you know if it happens!

[Elissa55 8]

Do you mind if I ask who your surgeon is-I would like my bariatric surgeons office to call her to see where she got the information-they have been waiting for the word:)

[healthy2bmomof3 0]

Just called Tricare and was told there are no bulletins out regarding change of service. The guy I spoke to said that typically when there is a change in coverage they get info about it a week or two out.He told me to check the CPT code online. I did and it still shows up as not covered, he did say that sometimes that will happen when there has been an update, but coupled with the fact that it didn't look like (to him) there hasn been a change there most likely hasn't been a change. He was very nice and told me to check with my surgeon's office and have the doctor submit an authorization to verify- I do not have a surgeon yet (and will probably end up going to my MTF). I just wanted to update the thread with what I found out this morning. HOPEFULLY the guy I spoke to was wrong and that coverage will begin soon! Any other updates?

[marinewife 0]

When my surgeons office told Tricare was going to start covering it I called Tricare as well. They didn't know anything about it . But they also said sometimes they don't find out about new things that are covered until it happens . My surgeons office is submitting my case today for the sleeve. I should know in the next 2 weeks. I'll let you all know what happens.

[NewMeLinda 0]

Hi Susan, I see that you were approved for the Sleeve in July at the MTF on Bragg. Congratulations! I am the spouse of a Retiree. I was referred to Womack MTF in Oct 2012, but was approved to see a off-post civilian doctor. As we know, that won't work bc Tricare will not pay for the Sleeve off-post. I spoke to the bariatric clerk at Womack and she said one of their surgeons have been deployed. The doctor is expected back this Spring, but it may be some time before she take referrals from civilian doctors. (They have other drs, but they are not taking referrals.) Can you tell me who I need to talk to in order to get into the program now. I am tired of waiting. I am also afraid that if I wait until the doctor returns, they still may not take me.

[samakar1516 1]

NewMeLinda.......hi, sorry it took so long to reply. Have had a lot going on and not thinking about looking at the posts. Have you had any progress? I had my surgery June17th, after waiting and working on this for over a year! Let me know what's going on with you.....talk to you soon.

[Doing It 4 Them 84]

Hi Susan' date=' I see that you were approved for the Sleeve in July at the MTF on Bragg. Congratulations! I am the spouse of a Retiree. I was referred to Womack MTF in Oct 2012, but was approved to see a off-post civilian doctor. As we know, that won't work bc Tricare will not pay for the Sleeve off-post. I spoke to the bariatric clerk at Womack and she said one of their surgeons have been deployed. The doctor is expected back this Spring, but it may be some time before she take referrals from civilian doctors. (They have other drs, but they are not taking referrals.) Can you tell me who I need to talk to in order to get into the program now. I am tired of waiting. I am also afraid that if I wait until the doctor returns, they still may not take me.[/quote']

NewMeLinda- Are you having any luck with Womack? My husband is a Navy Reservist and I tried to go through Womack too. It has been a headache! My civilian dr sent in 4 referrals to Tricare. I was approved for a civilian dr twice and this dr doesn't perform bariatric surgery lol. Tricare told me they don't understand why the referrals were sent to them because Womack is their own entity. I was told I couldn't go to Womack because my husband isn't active duty now.

I really want to go to Womack because of VSG. I gave up and decided to go back to the first place where I attended their seminar. I had already cancelled my April 29th appointment for psych eval, nutrition and talk to surgeon because I wanted to wait on Womack. Now I have another appointment with them on July 15th.

I was told that Tricare may approve VSG by August. I'm hoping this is true. My husband will only has Tricare Reserve Select until August 2014. I definitely want to have my surgery before then because my insurance won't cover it.