Tricare approval once referral is in place?

[Autumn2013 27]

:confused:Is it easy to get approved for surgery by Tricare once you have your Pcm's referral in process??? I am 220 lbs 5'5 and I will be meeting with my surgeon at the MTF for a full exam at the end of the month. I'm just crossing my fingers and really hoping Tricare will approve me for surgery...I have never been this anxious or nervous about anything in my life...Well if anyone can help or has gotten smooth approval please share your expeirence...Thanks!

[irideaqh 0]

I think approval is very easy as long as you meet Tricare's requirements. Once I got my PCM referral for lapband, I was approved by Tricare very quickly. My only hold up was that the PCM referred me to a doctor that was not a "Center of Excellence" doctor, but once Tricare changed my referral to another doctor I was approved the next day.

Good luck.

[Autumn2013 27]

Thank you Lisa!!! For the most part i've been hearing Tricare is one of the more easier insurances to get approval from...so hopefully!!! It looks like ur doing awesome!

[gina s. 0]

I'm in the same situation as you.....Tricare has approved me to see the surgeon, but hasn't approved the actual surgery. I have an appointment on the 25th, and then the surgeon's office will send their information to Tricare to get approval for the actual procedure. I feel the same way as you, I'm worried and anxious about not getting approved. Good luck and let us know how it goes!!!

[Autumn2013 27]

Thanks Gina goodluck to you too...I will let u know how everything goes keep me on posted on how ur approval goes!!!

[Jesusislove 26]

irideagh, you have lost 22lbs in several weeks? You are doing great. Are you still sore or in any pain? I getting ready to go in this month to have the procedure done. Thanks.

[feelgoodagain 0]

I saw my surgeon today and they are submitting the request for approval today. The insurance rep in the doc's office said it usually only takes a day or so to get your approval back. I do know that Tricares rules you have to be 100 lbs over your ideal weight for your height. I'm 5'5 and my ideal weight they said was 129 so I had to be atleast 229 lbs or over that.

[JenniLeen 0]

I just went today for my sugery consultation. Now I have to have my psych eval and then the surgeon will submit everything to Tricare for approval. I am really nervous that they aren't going to approve me! I have my psych eval on the 22nd of April and the doc said that I should be done with surgery and everything by this time next month!!! I'm excited but nervous too!! Anyone have any experience not getting approved for the surgery??

[feelgoodagain 0]

They called me this morning and I'm scheduled for surgery 1 May! So, it only took one day for the approval once sent in. WOW:lol: am I excited.

[irideaqh 0]

Trell,

I have already lost 31 lbs as of today (11 lbs were pre-op diet). I was only sore for about a week after surgery, but nothing too bad. I go in for my first fill in 2 weeks.

Good luck on your surgery.

[ready_2_lose 0]

Hi there. My primary care doctor called me today to tell me that plastics won't do the surgery because my BMI is "only" 38. Other than that, my sugar is slightly elevated but I am very healthy. I am thinking that it didn't even go through Tricare since I have to go to a Military Installation, they denied it in-house. I am bummed. Anyone have any suggestions?

Thanks!

~Dana

[ready_2_lose 0]

Okay, now Tricare called today to tell me I was approved to go to the surgeon for my initial visits! I am psyched! I guess it was just the MTF that was saying I wouldn't get approved. I sure was bummed but now things are looking up!

How are you guys doing with your approval?

[armywife4life 0]

okay today was my psych eval it was like 15min long, i have completed everything else and about to turn in paperwork to tricare tomorrow. so keep your fingers crossed for me:thumbup:

[ready_2_lose 0]

Best of Luck!

[AZChick289 1]

OK put me on the wagon too.. WE will all sit and wait together. Have all my pretesting in and now waiting for the surgeons office to submit the info .. Like eveyone so nervous and scared at the same time .. We can do this as miltary wives this is nothing compared to what we have been through .. All my prayers are with you all .. This site is so wonderful

AZChick (Waitng in Arizona) retired army wife