Jump to content
×
Are you looking for the BariatricPal Store? Go now!

External appeal Tricare?



Recommended Posts

Hello I had my surgery done two years ago and meet the requirements through a army hospital. At time of surgery I loss weight and was down to a BMI of 33.8 and I had two co morbidities. Fast forward to today and I need a revision because my sleeved failed( doctors error). Tricare denied me and my appeal because I don't meet the civilian standards from my original surgery. I meet them now though but because at the time of surgery I was under BMI. I am going to do an external appeal because I need a revision. Any help on what I can do or add to my appeal would be great. Also if you had an external appeal with Tricare could you let me know how the process was! Thanks

Share this post


Link to post
Share on other sites

@@Schoe394 I don't think you can do an external appeal with Tricare. You're in WA, correct? Did you have your surgery at Madigan? If so, have you gone through all the hoops at the facility to try to get them to help you with Tricare? If you're Standard vs Prime, you may have no other options.

Also, you said your sleeve failed due to surgical error...do you have this documented by another surgeon? You may be able to go back to that surgeon and have her/him help you with the appeal.

Share this post


Link to post
Share on other sites

Tricare said I can do an external appeal and are sending me the paperwork to do it. I was in Washington when I got the original surgery done and now in Illinois. My new surgeon has written a letter saying that it was a error and that I will need to have a revision but I still got denied.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×