LacedUp 44 Posted August 24, 2013 Hubs is in the AF and we are stationed at Tinker. We have tricare south which is Humana military, anyone else dealt with them? How long did it take to get the authorization once it was submitted? Share this post Link to post Share on other sites
Jacqueline K 93 Posted August 24, 2013 There is another lady here I talk to all the time that used same surgeon I did. She recently got moved to another station though in Kansas. Her username is ArmyofMe. Her husband just got back from active duty after her surgery. I think her approval was fairly easy. Sent from my iPhone using RNYTalk 1 LacedUp reacted to this Share this post Link to post Share on other sites
LacedUp 44 Posted August 24, 2013 Thanks! I'll try to find her, and that's good news about the easy part! Share this post Link to post Share on other sites
ajustice 484 Posted August 24, 2013 Hubs is in the AF and we are stationed at Tinker. We have tricare south which is Humana military' date=' anyone else dealt with them? How long did it take to get the authorization once it was submitted? [/quote'] AF wife here. Have Tricare south. Wasn't nearly as bad as I though. Approval came swift. Even your psych appt is covered. Nutrition services aren't. 1 LacedUp reacted to this Share this post Link to post Share on other sites
kraney 219 Posted August 24, 2013 We have Tricare west. Everything for my surgery including nutrition was covered. Took about a month and a half between getting referral from PCM and having surgery. HW 229, SW 214, CW 155 RNY 3/14/13 Share this post Link to post Share on other sites
happiness0325 10 Posted August 25, 2013 Hubs is in the AF and we are stationed at Tinker. We have tricare south which is Humana military' date=' anyone else dealt with them? How long did it take to get the authorization once it was submitted? [/quote'] Hi i have tricare north. They approved me really fast. My doctor is the one that recommended it for me. Everything was covered for me. I had everything done at a military hospital. Share this post Link to post Share on other sites
LacedUp 44 Posted August 25, 2013 Thanks ladies! I'm glad Humana isn't going to be a pain to deal with. I have Tricare Prime but Im having the surgery with an off base surgeon. I'm hoping that the only costs I'll have is the nutrition appointments.....so far so good. I'm just hoping the auth comes through quickly. Share this post Link to post Share on other sites
ajustice 484 Posted August 25, 2013 Thanks ladies! I'm glad Humana isn't going to be a pain to deal with. I have Tricare Prime but Im having the surgery with an off base surgeon. I'm hoping that the only costs I'll have is the nutrition appointments.....so far so good. I'm just hoping the auth comes through quickly. Honestly this was the one thing with Tricare I felt that ironically I didn't hit some kinda issue with. I got my referral to a off base surgeon and it went through swiftly. I paid $400 program fee and $50 nutritionist. Not to bad. Good luck Share this post Link to post Share on other sites
mrs.katie 27 Posted August 25, 2013 I am currently in the hospital and I had my RNY the 22nd. I used Dr. Echevarria at St. Joseph's Hospital in Tampa, FL. I had my first visit with him June 9. I have Tricare Prime. Tricare required nothing. My doctor required me to visit an EGD, a nutritionist, a psychologist, and a fitness expert. They submitted approval on August 7th and it was approved on the 9th. I have no co-morbidities, but I was 33 with a BMI of 60. My total out-of-pocket was $360. That was for the nutritionist, psychologist and fitness expert. They didn't accept insurance. Tricare probably would have reimbursed me but, let's be honest, I was too lazy to submit the paperwork. By the way, Tricare covers skin removal and breast augmentations too. 1 LacedUp reacted to this Share this post Link to post Share on other sites
aba9903 35 Posted August 25, 2013 Army wife here. Dealt with Tricare South with surgery. Only out of pocket costs were $25 for my nutritionist visit and then a little over $200 for my pre/post op kit (protein and vitamins). Auth was submitted on a Friday, I was approved by Thursday. This was all done by a civilian doc. My total bill was $61,000 which I paid none of. Yes, strangely this was one thing I never had an issue with when it came to Tricare! 1 LacedUp reacted to this Share this post Link to post Share on other sites
ArmyOfMe 82 Posted August 25, 2013 Jacqueline is correct. I had my surgery while still under Tricare South (Standard plan) with the same surgeon as hers. I am very happy I didn't have to go thru this process while under Tricare West. They are still all over the place since UHC took over. I started the process end of March and had my surgery in May. All Tricare wanted was 3 months of PCM supervised diet. Rest of the paperwork like medical history for the past 3-5 years, I provided myself. I had every doctor that treated me sign a letter of medical necessity which I wrote myself, as well as my weight history starting 8 years old to present. I also wrote Tricare a personal letter as to why this surgery would be in mine and their benefit. I was approved in a week. I pretty much bombarded them with every paperwork I put my hands on and was weight related. My Tricare co-pay was 25. Rest of the surgeon/nutritionist/psych eval/fitness eval. fees were my personal responsibility. Tricare does not cover any of that. Remember, they're a bureaucratic entity. In the long run, they want to save money not spend. Good luck to you. Share this post Link to post Share on other sites
kespy74 103 Posted September 22, 2013 This gives me some hope!! . I also have Tricare Prime and am calling my PCP tomorrow. I really hope it will go smoothly. I'm not close to any base, so I go through civilian physicians entirely. Keeping my fingers crossed. Share this post Link to post Share on other sites
emilybrokaw 1 Posted September 23, 2013 My husband is active duty navy and I went through tricare west. I just had my surgery on September 16, and I felt like the process was fairly easy. I asked my PCM for the referral for surgery, and she submitted it. I had to do 6 months of weigh ins with her and had to make sure she documented what I was doing different in my diet and exercise. I almost had the surgery when we were in the south region and they didn't require the 6 month diet. You can go to the tricare page and search for bariatric surgery in the "what's covered" section and it'll tell you all the requirements Share this post Link to post Share on other sites
silvermonarch 0 Posted September 25, 2013 I have TriCare Prime and am in TX. Everything here is covered. I have just started the process a few weeks ago, but through our on base hospital EVERYTHING is provided. Nutritionist, psych eval, labs, support groups, sleep study, ect. I have completed almost all of the requirements just working on the nutrition classes now. Two more to go. It seems like everyone has had a slightly different experience depending on their location. That can lead to a lot of confusion. =( Good luck! Share this post Link to post Share on other sites
krazyladya 20 Posted September 26, 2013 I am in Va beach and it only took me 6 months and I never had to talk to tricare or anything my surgeon gave me list of what I needed to do and that was it. 1 Greenfeather65 reacted to this Share this post Link to post Share on other sites