Post Sleeve Insurance Coverage Outside Of An Mtf

[gingersnap 11]

I'm in the process of getting my Sleeve done at Fort Gordon in the near future but I live about 3hours away in Charleston, SC. So here is my big question. What if after my surgery I have a medical problem say 6months to a year out and I need to go to a civilian ER. It turns out that say I'm dehydrated from not being able to get in enough fluids because I have the sleeve and I'm hospitalized for two days. Will that be covered by Tricare or would I be taking the responsibility for the cost?

I'm sure their are a million scenarios out there but I'm trying to get a grasp of what exactly I'm getting into financially. Because it's not just a health risk but a financial risk too!

[smellbug 43]

Hey Gingersnap

I am pre-op so I do not know for sure if Tri-Care will cover a hospital stay due to complication of the sleeve. With that being said I think that they would. I am having the sleeve done here in Jacksonville Fl. at a MTF. I am not loosing any coverage in insurance so if I have an emergancy we are able to go to any ER and be covered. As a active duty spouse it is always a possiblity of being moved to an area that does not have a military hospital for us to go. For example we lived in Maine for awhile and there was no medical on base all of my families medical care was done by civilian providers. I have read on some of the boards here people mentioned they can not get insurance for a year after having the sleeve, but that is not the case here we are already insured. I say yes you would be covered. The best bet is to call Tri-care and ask. Also I am Tri-Care Prime. Hope I helped.

[gingersnap 11]

If my Surgeon Dr. Choi is correct. He states that if their is an emergency Tricare will cover it. However, they will not cover anything routine and I would have to go to an MTF.

[clk 3,519]

I self-paid in Mexico. There really was no "routine" follow up, other than labs. I had some done shortly after surgery at a MTF and some done with Tricare Prime Remote and all were covered with problem. I had no complications so I can't share that experience.

Tricare covers us, period. I was worried when I got pregnant with twins via self-funded IVF that we'd have a problem if there were complications but they cover us with no gaps and no issues. I'd say 90% of my time as a spouse has been spent on either Tricare Overseas or Tricare Prime Remote and I've never had a problem with coverage.

~Cheri

[gingersnap 11]

Cheri,

Thanks so much for sharing your experience and congratulations about the twins! I asked my surgeon and he said that Tricare would cover anything that was an "emergency" but nothing routine. So that put my fears at ease. I just hope he is right if I should ever need it.

My biggest fear is needing emergency care due to a leak and ending up with $20,000 bill.

Congratulations on your weight loss, are you happy with the sleeve?

[lovex5 25]

I am really concerned about this also. The idea of having a problem later down the road and winding up with a huge hospital bill does concern me. If tricare ever decides to cover vsg (yeah right) they might refund those charges but of course it's not a guarantee.