Wow- just informed Tricare not covering sleeve

[Guest]

I'm in my 5th month of the supervised diet - all preop stuff done- just waiting for time to pass and was informed today (by chance!!) that Triwest will not cover the sleeve. I am in shock. I called Tricare and they confirmed this, but said maybe a different code would work? The CPT code given by my doctors office is 43775.

Has this happened to anyone else? I live in Alaska so going down to the lower 48 would be a challenge. And costly.

[Tryingtobringsexyback 17]

Go to Mexico I did almost two weeks ago. Dr. Guillermo Alvarez. It was fine no troubles.

[Guest]

It's cost prohibitive for me at this time

But I'd love to hear about your experience! How are you doing with everything?

[mswanson502 0]

I was told this also. I was not given another code to try because I hadn't started the process yet. I just figured I'd have to have the gastric bypass done instead. Anyone know why Tricare isn't covering it now?

[Guest]

Well my drs office says it will be a few months before they cover the sleeve. They think Bc Medicare covers it now, tricare will follow suit, but they are much slower about it. Next month I will be finished w my 6 month supervised diet, so they are going to submit for the sleeve anyway. I'm not counting on an approval.

[mswanson502 0]

I sure hope it works out for you. I can imagine how stressful it is waiting. : (

[Doing It 4 Them 84]

I have Tricare Reserve Select and was told today that they won't cover the sleeve. The insurance lady at Dr office said it may be 12 - 18 months before Tricare will approve the sleeve for coverage. Tricare will cover lapband or bypass with an out of pocket expense of $150. My 1st appointment is April 29th for consult, psych eval and nutritionist. I was hoping it may be approved during my 6 month diet but I've found out I only need to do 3 months.

I've read that people are getting it done at Military hospitals and clinics. I called a clinic 90 minutes away and they do it. I need to have my civilian doctor send a bariatric surgery referral and go from there.

I don't understand why Tricare won't approve it, but you can have it done at a military hospital.

[eme2386 2]

I have tricare prime and I am having the sleeve surgery on the 24th. I was told it is corded because I am having it at a military hospital. If I were to go to a hospital off post, only the bypass would be covered.

[eme2386 2]

Covered* sorry darn auto correct

[Guest]

Hi- thanks for all the responses. As luck should have it, my local MTF is starting to do bariatric surgeries next month. I have already met w the surgeon. :0). He will be doing the sleeve hopefully next month. I am finished w all my preop stuff so it's just a waiting game at the moment.

It won't seem real until I get a date though. :0)

[Guest]

Oh and curious, to those that had it done at an MTF, did your center require a 6 month supervised diet? Ours is (luckily I have already completed it), but new patients will have to have the 6 months first.

[eme2386 2]

Mine did not. The only diet I have to do is a two week pre op liquid one. I started it yesterday.

[Guest]

Interesting!!

[ndove 1]

I realize this is an old post, but are there any new updates to triwest or uhc covering the sleeve? If so, do they still require the 6 month diet and any pointers to make sure I put myself in the best possible position to get approved?

Sent from my iPhone using the BariatricPal App

[donnad0118 13]

I realize this is an old post, but are there any new updates to triwest or uhc covering the sleeve? If so, do they still require the 6 month diet and any pointers to make sure I put myself in the best possible position to get approved?

Sent from my iPhone using the BariatricPal App

I am curious too if there have been any updates. I have Tricare Reserve Select North Region and I know they cover they sleeve, I'm just curious if they require a 3 month or 6 month supervised diet or non at all. The website doesn't state any. I go next Wednesday for my first consultation with the surgeon and nutritionist. Hoping I will find out something then.