Tricare from band to RNY

[nagrin 6]

Did anyone have TRICARE and had approved to had the ban removed and had RNY

[tkee99516 2]

I have Tricare. Had lap band put in on 8/2009. It slipped & I had it removed at the MTF 03/2012. I'm now in process trying to get a RNY approved with Tricare. Just had my first visit today with the off base surgeon, who will submit the auth to Tricare this Friday. If approved, will have the surgery on 3-11-13.

[sapperwife26 7]

I have tricare but I heard once you have one you can't have another. But I'm sure there's away around it. What region are you in. Ill ask around and see what I can find out.

[tkee99516 2]

Here's what was faxed to me by TriWest:

TriWest will cover only ONE bariatric surgery in a lifetime, except of there is a complication from the original covered surgery (slip of a band, etc.).

Repeal/Revision of a covered bariatric surgical procedure, due to technical failure of the original procedure, is covered when ALL of the following criteria are met:

1) The patient has failed to achieve adequate weight loss, which is defined as failure to lose at least 50% of excess body weight or failure to achieve body weight to within 10% of ideal body weight, at least TWO years following the original surgery

2) the patient met ALL the screening criteria, including BMI requirements of the original procedure, AND HAS BEEN COMPLIANT WITH A PRESCRIBED NUTRITION AND EXERCISE PROGRAM FOLLOWING THE ORIGINAL SURGERY.

3) The requested procedure is a covered bariatric surgery.

Hope this helps.

[tika76 21]

Did anyone have TRICARE and had approved to had the ban removed and had RNY

Yes, I'm tricare south but they approved for band removal/ RNY revision due to major complications... I think it's all about what the doctors write in the letter....

[tkee99516 2]

Just rec'd notice this morning from TriWest that I have been approved for RNY! The auth was put in yesterday from the MD's office & they approved it less than 24 hours later. Guess they don't move as slow as I thought they would. Actually, I thought they would deny it & I'd have to go through the appeal process like I had to do with the Lap Band back in 2009.

[nagrin 6]

Just rec'd notice this morning from TriWest that I have been approved for RNY! The auth was put in yesterday from the MD's office & they approved it less than 24 hours later. Guess they don't move as slow as I thought they would. Actually' date=' I thought they would deny it & I'd have to go through the appeal process like I had to do with the Lap Band back in 2009.[/quote']

Hi! Update, I had approved in 1 day for my band removed and RNY, I was so happy. I had my band removed on Friday, I have a open incision because my port was infected, so I have to wait that to heal and after that will we schedule my RNY can't wait.