Tricare now approves lapband

[dallman 0]

Good Luck to everyone. The Two week diet is a killer.

Don

[minpinmom 2]

I am still awaiting my approval, but I can't believe a 2 week diet is so close in my future. Keep me informed Dallman, I feel we have a "Tricare bond" :-)

[LiveLoveLaugh 0]

Hi all-wanted to know what Tricare requires to obtain approval and what else may be needed for coverage. My girl friend has Tricare and she wants the band also. please any help would be great. What has your experience been like so far???

Cynthia

[mommakatx2 0]

Yes, can those of you who have been approved please tell us what Tricare required? Not your surgeon, just Tricare. Please tell us your starting BMI and comorbidities, if any.

Thanks and congratulations to all of you who have been successful!

[nanajo 0]

I called the bariatirc surgeon's office today,and she said that they had heard that the lap band was going to be covered, but had not received anything on it yet. So I can't even get a screening appointment until they get something from Tricare. However, she did ask me to send her anything official that I foun. I tried the link that was on the new release, and it did not work for me. I googled a lot, and I am good at googling but came up with nothing official looking. I entered all of the information about the manual, section number etc.

Does anyone have a direct link to something from Tricare, or information abut how to access the page I need from the address given in the news release?

Thanks,

Mary Jo

[minpinmom 2]

If the link isn't showing up, I have a copy of the page (PDF) saved on my computer. I used it when I went to my Dr. I don't think I can attach it here - but send me your email address and I can email it to you.

Wendy

[nanajo 0]

My address is nanajo46@gmail.com. Thanks.

[minpinmom 2]

Email sent

[mommakatx2 0]

Minpinmom, just wanted to say Good Luck to you!!!! I submitted my packet to the surgeons office today, which was the 2nd step I had to take, so I've got a while longer yet before I even get to the insurance submission.

Keep us posted!!

[Jesusislove 26]

I was told by Humana Tricare that all systems should be updated today in the system. I already have my visits authorized to see my doctor before today, a week ago. You must be 100lbs overweight with comorbidities according to the metropolitan life chart. If you fall 100lbs overweight on the chart you're good. If you should weigh 135lbs and you weight 270 or more, you automatically qualify, that is what 200% means. BMI has no bearing with tricare only weight and height for you bone structure. Weight and bone structure is based on the Metropolitan life charts. You will need clearances from you cardiologist, your doctor, nutrition eval, and pschy eval, after your packet is accepted by your bariatric doctor.

[CnSHawk 0]

minpinmom, would you mind emailing it to me as well. I go see doc this week and would love to use tricare instead of Cigna. Thanks for all you guys have done to keep us informed. I have reading this forum for some time now and finally feel that I am ready to get this ball rolling. shawkins1@comcast.net

[minpinmom 2]

minpinmom, would you mind emailing it to me as well. I go see doc this week and would love to use tricare instead of Cigna. Thanks for all you guys have done to keep us informed. I have reading this forum for some time now and finally feel that I am ready to get this ball rolling. shawkins1@comcast.net

Email sent!

Good Luck

[cobrien78 0]

I'm here at Lackland afb, tx. I am hoping to go to an approved civ. dr. The only thing is with these metropolitan life charts I fall into the medium frame and am 100lbs. over the minimum weight requirement for medium frame women of my height. Does this still count? I do have several co-morbid conditions however. They do have a bariatric surgeon here but, they only have one! So could I get approved to go off base if I wanted, if the surgeon accepts tricare? Any info would be great!

[Sgt Bob 1]

I'm here at Lackland afb, tx. I am hoping to go to an approved civ. dr. The only thing is with these metropolitan life charts I fall into the medium frame and am 100lbs. over the minimum weight requirement for medium frame women of my height. Does this still count? I do have several co-morbid conditions however. They do have a bariatric surgeon here but, they only have one! So could I get approved to go off base if I wanted, if the surgeon accepts tricare? Any info would be great!

I think it depends on what flavor of Tricare you have. I have Tricare Standard and they have told me repeatedly that I can go wherever I want for my care. The only difference is, if I go "out of network" my co-pay is 25% instead of 20%.

I think if you are a military dependent, you might have to go to a MTF, but you should double check to make sure.

If you call your Tricare regional office, they should be able to tell you.

You can find their number and a lot of other information at Tricare.com.

I looked up something at Tricare.com which may be helpful to you.

When You'll Visit a Non-Network Provider

• When enrolled in TRICARE Prime Remote, you may visit a TRICARE-authorized, non-network provider if a network provider is not available.
  
• When using TRICARE Standard and Extra, you may visit any TRICARE-authorized, non-network provider. When you do, you're using the Standard option.
  
• When using TRICARE Reserve Select, you may visit any TRICARE-authorized, non-network provider.
  
• When enrolled in TRICARE Prime, you're typically not allowed to visit a non-network provider unless authorized by your regional contractor. If you do, you'll pay higher out-of-pocket costs under the point-of-service option.

Non-Network Providers

[cobrien78 0]

Thanks for the info Sgt Bob!