Tricare Standard Steps

[mynmann 0]

Okay, I'm new to Tricare. Really new. My coverage doesn't even start until March 1st. I've already attended a seminar though... and the doctor their said he takes Tricare (though he didn't think Tricare payed anything for the surgury yet, silly guy).

Anyways, I need to know how you do this. Can I call the surgeon direct. Do I need to see a physician first? Does Tricare assign me a physician or do I get to pick one?

HELP! :biggrin:

[minpinmom 2]

As soon as your coverage starts you either pick a PCM (Primary Care Manager) or they may assign you one - (they did this when we were Active Duty).

You MUST go to your PCM FIRST, and get a referral to see the surgeon that you want. Tricare will NOT pay for it unless you get a referral from your regular Dr. My referrals normally take 4-6 days to come through.

Once you get on Tricare, email me and I will walk you through how to setup an online account with them (very easy) That way you can track your referrals and everything in real time - you can see the info as soon as they input it, instead of waiting for it to come in the mail.

Wendy@BeldwinKennels.com

Hope this helps!

[KatsenD 0]

Hi, I am on Tricare and got my referral approved yesterday. I go next week to a required seminar, then on to the doctor appointment. Tricare used to not pay for the lapband, but they do now. It's real easy. You pay a co-pay $12 for doctor visits, and depending on how long you stay in the hospital, a maximum of $25. I was approved for 4 visits, but the more I read about this procedure, I see where 12 visits may follow the surgery. Humane told me, the doctor will request more visits. I'm sure it will all work out.

[mynmann 0]

How do I go about picking my PCM... do I call Tricare? Also, does anyone know where I can find a list of Tricare "accepted" doctors. I have a surgeon in mind but don't want to bother getting my hopes up if he's not on the list of approved doctors.

Hey, Minpinmom.... how are you feelings. You're in my thoughts and prayers!

Myn

[minpinmom 2]

I am feeling GREAT! Today was my one week check up and everything is going perfect. I can't believe how easy it all was.

Here is the link I use to find a Dr. - I stay signed in, so I am not sure if the option is available or not. Here is the link to try.

Humana Military

[Emily'sDad 0]

I didn't even bother picking a PCM. I didn't have one assigned and just made an appointment with whom ever they had. Didn't seem to make a differance I was still approved. Tricare Prime South

[kyplaybunny 0]

we have been on tricare for sometime my husband is active duty u have to pick a dr in the network u can go to tricare.com where u are in north or south region and get a list of drs

[armywife4life 0]

minpinmom,

does this work if you have tricare overseas? to be able to do the online stuff? im stationed in germany

[minpinmom 2]

Wow, I don't know that one. Lucky you to be in Germany, my sister and I were born in Frankfurt - my family spent 9 years there and loved it, we returned stateside when I was about 2 so I don't even remember it.

I don't have a clue about Tricare remote -sorry.

[VegasJen 0]

Hello all,

I am Tricare Standard and was told by Tricare that I can Self-Refer direct to the surgeon (I am TriWEST). Tricare PRIME needs the referreal, but STANDARD patients can go directly to the surgeon, who proves medical necessity to Tricare for you. I would go ahead and attend a seminar and ask the office staff there what to do next. My surgeon's office staff is very helpful, and knows the ins and outs of getting Tricare approvals.

Good Luck!:thumbup:

[Meekie 5]

We are in Germany, too. I went to my PCM last week and got a referral. I went in to talk to the lady at tricare who is helping me because of the language barrier. Tricare in Germany has liasons to help with the language barrier. I received a call from my PCM who told me I needed to see the nutritionist and psych doctor. The liason called Dr. Weiner in Frankfurt and made me an appt for an evaluation. My appt is not until May. That's how far booked they are. But, I am seeing the nutritionist at Landstuhl.

Where are you in Germany? I'm in Wiesbaden.

Stay in touch to see if we can walk through this together.

[Sgt Bob 1]

Hello all,

I am Tricare Standard and was told by Tricare that I can Self-Refer direct to the surgeon (I am TriWEST). Tricare PRIME needs the referreal, but STANDARD patients can go directly to the surgeon, who proves medical necessity to Tricare for you. I would go ahead and attend a seminar and ask the office staff there what to do next. My surgeon's office staff is very helpful, and knows the ins and outs of getting Tricare approvals.

Good Luck!:mad2:

I have Tricare Standard as well and have been told the same thing repeatedly. I have gone to specialists without referral a few times and Tricare has had no problem with it.

Congrats Wendy! Glad its going well for you!

[armywife4life 0]

meekie, hi, wow im so glad i ran into someone else here. I went to tri care rep and she said that tri care does not approve for overseas yet? I was like dang..But your rep said it does? I have heard of doctor weiner,thats who i want to see. I am in schweinfurt. Geesh okay i guess the ill have to call the lady again and ask, man im so mad...Okay also i need to got to my PCM and ask for a referrel first to right?

oh wow i have so many darn questions LOL.

[Meekie 5]

My rep says that they do. They just started in January 08. She is waiting for my PCM to sign off on the paperwork. My PCM is the one giving me a hard time. She says I need to go through 6 months of supervised weigh-ins, psych eval, and nutrition before she will sign off. She says I need to lose at least 10-15 lbs on my own. I am soooo disappointed in that. If I could do all of that, I wouldn't need the band. Please stay in touch, even if you have to PM me and let me know how things are going for you.

[armywife4life 0]

Meekie,

keep your head up missy, don't let them get you down. I have an appt. with my pcm April 28th, and im ready to go into battle. Im going to hold my ground and not give up. My rep, said i have to stop in before i see him and get a morbid obesity form. Then he fills it out and I take it back to tricare. Sooo here's hopin all goes well. Also have you ever done stuff online, like the calorie count website, etc...that might accept that as 6 mths of weightloss crapola. I sent you my IM and email address chicky so use it if you need it. Hooah!!!