Tricare humana

[Elfling 2]

Hi everyone, so tricare released its new benefits today does anyone know if tge gastric sleeve is listed yet? Medicare will cover it, not sure why Tricare wouldn't?

[Odiemove75 0]

I'd like to know the answer to this

[catdaddy 232]

This is straight from the web site:

TRICARE covers the following open or laparoscopic bariatric surgical procedures:

Roux-en-Y gastric bypass

Vertical banded gastroplasty

Gastroplasty (stomach stapling)

Adjustable gastric banding (i.e., adjustable LAP-BAND®)

All of the following conditions must be met to qualify:

You're at least 18 years old or you must provide documentation of completion of bone growth.

You were unsuccessful with non-surgical medical treatments for obesity. Your medical records must show your failed attempts.

Diet programs, such as Weight Watchers®* and Jenny Craig*, are acceptable methods of dietary management, as long as there are monthly clinical visits with your doctor and medical documentation of your participation and your progress throughout the course of the dietary program. *These programs are not covered by TRICARE.

Physician-supervised programs made-up of only weight-loss medication management, do not meet this requirement.

You have proof of one of the following:

A body-mass index greater than or equal to 40 kilograms per meter squared (kg/m2); or

A body-mass index of 35-39.9 kg/m2 with one clinically significant comorbidity, including but not limited to, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea, Pickwickian syndrome, hypertension, coronary artery disease, obesity-related cardiomyopathy, or pulmonary hypertension.

TRICARE doesn't cover the following services:

Office visits solely for the treatment of obesity

Non-surgical procedures for treatment of obesity

Nutrition and diet counseling

Biliopancreatic bypass (jejunoileal bypass, Scopinaro procedure)

Gastric bubble or balloon

Sleeve gastrectomy

Gastric wrapping/open gastric banding

Unlisted procedures

[ProjectMe 909]

Gastric sleeve is covered on a military base. I just had it 12/16. My base also covers gastric bypass. The surgeons/program will not do lap band, but will do conversions. Also all nutrition, psych, follow up care, etc. are also covered on the military base.

Edited January 2, 2015 by ProjectMe