Tricare Standard

[bctrojanette32 0]

My husband and I have just recently gotten married. I am currently on Tricare Standard because of being out of network for North/South etc, and I am still living at home until the end of the year and not currently with my husband. I meet all requirements in BMI and have PCOS. Does anyone know if I should run into any problems being only through Tricare Standard for the roux en y surgery? Thanks

[ArmyOfMe 82]

My husband and I have just recently gotten married. I am currently on Tricare Standard because of being out of network for North/South etc, and I am still living at home until the end of the year and not currently with my husband. I meet all requirements in BMI and have PCOS. Does anyone know if I should run into any problems being only through Tricare Standard for the roux en y surgery? Thanks

I am undergoing RNY surgery soon with Tricare (Standard plan). I was told by 5 Reps (I called them a lot with various questions) that there is no 6 month diet requirement, I can chose my Bariatric surgeon as long as he is in network and apporved by Tricare and I will have co-pays, of course. Everything else is at the surgeon's discretion and how they present the case. Also, coding has to be correct or the patient might risk enormous out of pocket costs.

You can find a list of Tricare approved Biariatric surgeons on the Tricare website under Provider Search. Shop around, interview them and see which one is more experienced and give you the facts and also, which one you are most comfortable with.

Good luck.

[ArmyOfMe 82]

I also wanted to add this info for you. Hope it helps.

http://manuals.trica...a0+5a1+5a8+61c+

[consuela11 8]

I have tricare standard west and I have to do the 6 months of nut visits and the they pay 80 per after the deductible is met.

[chrystine 42]

I am retired Army and have a Tricare HMO. I know the hospital accepts the HMO (Martin's Point) but Martin's Point won't tell me whether they will cover me. They will only say "it has to be medically necessary." I started with a BMI of 43, GERD, high cholesterol, bad knees and back. I had to pay for the nutritionist, and six weeks of life style classes and loose 8% of my body weight to meet with the surgeon (1 lb to go!). I am going to be highly annoyed if I have gone to the expense and Martin's Point says "no". The surgeon I want said he's had no problem with Martin's Point though. I do know my PCP at the VA is 100% supportive and if need be, I will try to go through them. They don't use a Bariatric Center of Excellence though, which is important to me. Hoping for the best!

[StabMyFinger 19]

I have Tri care for life and they will cover the 20% that medicare doesn't. Just starting the process and have my fingers crossed that I pass all the other test, Also, I am 65.

[Nancy E. 44]

I have Tricare Standard (West) before starting this process. I asked specifically what requirements I needed to meet to qualify for the by-pass surgery. I have completed everything on the list and expected a surgery date first week in August, as did the bariatric center I will use. Well, it is past Aug. And I still have not been given the green light. I've called tori care twice this past month as was simply told I didn't qualify. Say what? I pointed out that I had called in the beginning of starting this and have fulfilled all the requirements including the ones the surgeon added, yet could not get an exact answer out of them. The bariatric center called twice and have appealed for me. Early last week I called insurance again and got same results so I called bariatrics who called them too. We should have heard back today but have not. I am so bummed out I just don't know what to do. My hips, knees, ankles, feet hurt so much I hate to stand up. I'm sick of being out of breath after just a few steps. I hate using a bi-pap machine with oxygen every night (real sexy, let me tell you!) and I hate going out of my house because of how I look. I'm sorry folks, I guess I just needed to get this off my chest because tears just don't cut it. If anyone has any ideas I'd appreciate them, if not, that's ok. Thanks for reading and letting me vent. Feeling sad in the west.