Anyone Use Tricare?

[WildcatGirl71 81]

I'm getting my ready to start my journey and have Tricare Select Reserve insurance (as a dependent). Although it pays for Bariatric surgery after many months of specific criteria to be met, I'm wondering if anyone else has used it and had any issues with coverage or last minute changes. Thanks in advance!

[mommatney 0]

I have Tricare and I am scheduled for a revision on September the 26th. My first surgery was through private insurance. I was trying to approved through my insurance through my job for almost 3 years. My doctor on base said Tricare would approve with just his recommendation. I went through the tests he suggested and he also wanted my surgery report from first surgery but I was unable to get it. My first attempt for revision the base doctors said there was nothing wrong with me. I even received a call from someone who was on panel that reviews surgery cases who basically told me to give up. My doctor said approval would be easy as long as I meet the requirements.

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[WildcatGirl71 81]

Thank you for answering. I am not using a base dr or hospital so I'm hoping there aren't any surprises. I've had pretty decent luck with Tricare so far.

Good luck with your revision surgery. May I ask why you need this additional surgery - is it common with bariatric or due to issues with your first surgeon?

[NolzGirl 16]

I have Tricare Prime, Active Duty... I'm a dependant. I'm not on base and have had NO problems or surprises! My surgery date is set for 9/13!!

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[WildcatGirl71 81]

Thank you! Good luck on your upcoming surgery!

[Nursegirl2803 1]

I have Tricare Prime, Active Duty... I'm a dependant. I'm not on base and have had NO problems or surprises! My surgery date is set for 9/13!!

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Where are you stationed?

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[Nursegirl2803 1]

I have tricare prime retired as a dependent. Tricare pd for my band 12 years ago in Oklahoma and now I want it revised to a sleeve. Going to see a surgeon in 2 weeks for evaluation. Regardless, they have to take out the band just hoping they will do the revision also.

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[WildcatGirl71 81]

Hi - thanks for answering. We are in Washington State and was on JBLM. My husband is Army Reserve now so we have Tricare Select Reserve. Wish I would've done this when we lived on base and he was active duty but I kept holding out for that "miracle diet" that was going to fix everything. lol

I called and talked to Tricare benefits over the phone about the details, just to make sure the surgeons office had everything, and it looks like the list they gave me is the same. I start my journey with my nutritionalist on Friday so I'm hoping by March 2018, I should have surgery scheduled. Just wish the process didn't take so long to get there. Hope everything works out for you on your revision. I'd love to hear how it goes!

[Nursegirl2803 1]

Why is it taking so long? I will not be a happy camper if I have to wait too long to get this band out..

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[WildcatGirl71 81]

Hi -

I have to go for 7 monthly visits (1 consult & 6 visits) for a physician supervised nutrition and exercise program (or a dietician). it's stupid really. Like i haven't tried everything under the sun already. I have to "prove" to them that i have been unsuccessful with non-surgical attempts for obesity. Like my weight and health aren't proof enough. It's very discouraging. The part that really sucks is that Tricare doesn't pay for nutrition counseling. This will be out of pocket expense. They will cover everything else but this.

You may not have the same criteria as i have though since yours is a revision. I hope not for your sake!

Edited September 11, 2017 by WildcatGirl71

[slebsn13 0]

Happy Friday!!! Just checking in to see how y'all are doing. Any updates???

I just started the process of trying to get approval from Tricare for my revision to the sleeve. I was banded 10/25/2004 and did great until 2009 when I had my first unfill. Now my band is virtually useless and only causes problems, not to mention that I am 20 lbs away from my pre-banded weight. Tricare did pay for my lapband surgery with no issues so I have my fingers crossed that they will approve my revision. Either way, this band has to come out.

Best wishes to all!

[lauratro 67]

I have Tricare Standard and we are stationed at JBLM in Washington State. I went through the 6 nutrition counseling and all of the requirements and had surgery on 7-27-17. It was super easy with Tricare...just had to jump through all the hoops

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[WildcatGirl71 81]

I have Tricare Standard and we are stationed at JBLM in Washington State. I went through the 6 nutrition counseling and all of the requirements and had surgery on 7-27-17. It was super easy with Tricare...just had to jump through all the hoops

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I’m glad to hear that! I was worried that I would go through all the steps and then get a denial.

[WildcatGirl71 81]

Happy Friday!!! Just checking in to see how y'all are doing. Any updates???
I just started the process of trying to get approval from Tricare for my revision to the sleeve. I was banded 10/25/2004 and did great until 2009 when I had my first unfill. Now my band is virtually useless and only causes problems, not to mention that I am 20 lbs away from my pre-banded weight. Tricare did pay for my lapband surgery with no issues so I have my fingers crossed that they will approve my revision. Either way, this band has to come out.
Best wishes to all!

Hoping you got good news about your revision. What did you find out? I’m still moving through all the prerequisites.

[slebsn13 0]

On 11/28/2017 at 8:34 PM, WildcatGirl71 said:

Hoping you got good news about your revision. What did you find out? I’m still moving through all the prerequisites.

Hi! I got an approval for my revision in less than 2 weeks and I am scheduled for surgery on 12/12/17. I think my surgeon did a great job documenting all of my ongoing problems with the band so I have medical necessity for its removal. When you add in the weight that I've gained back along with the return of my pre-diabetes, pre-hypertension, asthma and sleep apnea, then I'm sure that's what got me the revision to the sleeve approved. Looking forward to my sleeve adventure!

Good luck with working through the process, can't wait to hear how everything goes for you!

Take care!