help..please.

[dreamingvsg 2]

Hello im from Tacoma, Washington. And my insurance is tricare. I know Madigan has a seminar Jan 8 2014. But I guess first I have to see my pcp first for her to put in a console? My question is what do I say to her? And if she puts one in what happens next? Also..my next question is hard to get vsg or any other bariatric surgery approved by tricare. If not. How long does it usually take? I hope my questions are clear. Its 2am and all this is on my mind. Pleasw answer

[dreamingvsg 2]

Is it hard* sorry

[AJP1243 46]

Just tell your pcp that you are in need of a change and you have been thinking and researching WLS. Then ask for recommendations of places even though you know of places still ask and then s/he will give you what you need. Then after seminar you will begin your journey. You will find out what your insurance requires 3-6 months of Nutritionist visits, letter of medical necessity, psych eval ect. Then you get started on one then move on to the next. It can't be submitted to insurance till all they need/want is done. But your very very first thing is to find out if your insurance covers it or not by calling your insurance first. Then make appointment with pcp. When they direct you to your dr you have to also see if they accept your insurance at that particular place. Sorry such a long post. Just wanna help!

Edited December 20, 2014 by AJP1243

[#9grammy 274]

Tricare doesn't do the sleeve surgery. Only the bypass, I have Tricare and Medicare and I have to pay the 20% that Tricare was suppose to. If you get this done in a military hospital, hard to also, then it's free.

Even with my Medicare it's been almost 8 weeks and I still don't know if they are going to cover it. With Medicare you have surgery then submit your papers for approval! Insurance with the government is crazy...

[BLERDgirl 6,417]

You need a consult or referral for the seminar? Call them and double check usually the seminar doesn't require a referral. You get that once you have an appointment to met the surgeon and medical staff. The purpose of the seminar is to get information about the types of WLS the program offers and what it entails.

[BitterSweet* 835]

Type in the search bar "Tricare Insurance" and a few threads will come up. I've written a couple of long, detailed responses to your questions on some other posts. Message me if you still have questions and good luck on your weight loss journey!

[dreamingvsg 2]

Thank you guys so much. Theres to many mixed responses to this question. I've looked everywhere. If I get the sleeve and get approved I do want it at Madigan aka MTF. so hopefully that is covered. I went through this process before went to a seminar at Madigan two years ago, put myself on the list. Then a couple months after they called me to start the program but I couldn't cuz I stopped going to school so I was dropped from tricare. But I start school again January and will be back on tricare. This is my dream. Im 23. I have pcos. Which makes is soooo hard to lose weight ive tried anything and everything you can think of. (Atkins, hcg drops, pills, starvation, lots of cardio, workout girdles etc) nothing has helped. I also had asthma when I was in middle school. My bmi is 46.92 I believe. Not 100% sure. My main concern is I wanna beat pcos. In hopes one day I can have children. I know theres alot of hoops to go through. But im determined. I just want a new start. My parents are going through a divorce, the new year is about to begin ill be 24 in November I just wanna do this for me. But I also I have the worse luck in the world too. I have a feeling I'll do all these steps and not get approved or something .. I also came from a physically abusive relationship and gained at least 20 lbs so now im sitting at 265 and im short. I just hope and pray things will work out. Sorry for my long story. But if you have any more advice. Or details reguarding tricare. Sleeve. Steps tp take pr your own story and what you did to start all this. Please please let me know. I never been on a site like this. And just your guys comments alone makes me feel important. so thank you.

[BitterSweet* 835]

I wish you the best of luck. Part of this process involves a lot of research, which takes time. The answers to your questions are here, you just need to invest the time reading through the posts. There's no mixed replies. Tricare does not cover the sleeve. Period. Any referral you get outside of a military facility will be for a gastric bypass.

[dreamingvsg 2]

Well some people are telling me I can get the sleeve at Madigan on base. (Mtf) and tricare will cover it. And some people are telling me no. So there are mixed replies. That's why im confused. Thats all.

[BitterSweet* 835]

Any medical care received on a military base is free, so there's no Tricare insurance issues. Military bases such as Madigan that have bariatric programs are offering the sleeve, and since that facility is on base, there is no cost whatsoever.

Any referral to a bariatric program that is OUTSIDE of a military facility involves using Tricare insurance, and they will NOT cover the sleeve, only a gastric bypass.

You can call Tricare on your own and or access that information on their website. Doing so should clear up any confusion and mixed replies that you may be reading or getting from others.

[BitterSweet* 835]

@@dreamingvsg, Go to search, type in Tricare and under member, type in BitterSweet* ; two threads should pull up where someone else asked your same questions. Hopefully my replies will clear up some of your questions. Take care and good luck.

[dreamingvsg 2]

Okay. Sorry if you're annoyed haha. Just so desperate for answers.

[BitterSweet* 835]

@@dreamingvsg, You'll be fine and I'm not annoyed in the least. Whatever you decide to do, please take some time to do your research. I've been researching VSG for 9 months and I still feel ill prepared because there is so much to learn.

Use your eagerness and desperation for answers as a time to learn. The bariatric program here has a support group and I'm sure Madigan does as well. It's something you might enjoy and can get first habd information from those who have done what you are trying to do. You don't need a referral to attend the group. Just call the nutrition clinic on Ft. Lewis and ask when the next meeting is. You may also want to look on fb for an online support group specifically for Madigan. Ft. Stewart has one but I didn't join it. All of the people in the group had weight loss surgery well over a year ago and they still look like they are pre-op. I've learned way more on this site than the group and I dutifully write down the suggestions I find most helpful. Good luck to you.

[dreamingvsg 2]

They had surgery a year ago. And look like pre op still. Cuz it didnt work?

[BitterSweet* 835]

@@dreamingvsg, I don't know. They were all still really big women and it could just be that they started out with extreme BMIs. I need to lose 80lbs and they were my size or bigger and none of them looked happy either. I found the meeting very depressing and the majority of the questions the true pre-op people asked were quite amateur-ish. I had found all of those answers to the questions they posed from reading threads on this forum.

Also, don't just read the nice stuff. You need to also research and read the threads in the "Gastric Sleeve Complications Support Group" that is on this forum. The majority of people fly through VSG surgery without problems, but complications can and do occur, and some of them are difficult to correct. It's important that you make a very informed decision about this surgery because there is no going back.