Surgery is APPROVED - Tricare insurance

Long2BFree · June 20, 2008

I just saw my surgeon on Tuesday to get my surgery date for July 17th and just checked Tricare's website and I've been approved! Now this is going to become a reality! I feel very blessed as I'm the last patient my surgeon has accepted with my insurance.

minpinmom · June 20, 2008

WooHoo! Congratulations. What exciting news. Good luck and keep us informed!

Altoonasoup · June 20, 2008

I started this process with Anthem Blue Cross 2 years ago. At that time they denied me, saying my company had a direct exclusion of weight loss surgery. Now I have found out that 2 people in the company have gotten banded in the last year. Now I'm almost afraid to get my hopes up. I am going to have to start the process again because it has been long enough for me to have lost and gained and developed more co-morbidities. Insurance companies! Bah! :confused_smile:

aculberg · June 20, 2008

Thats so great! I too am hoping to get approved with Tricare, have my initial consult next week, and then they will submit it all from there, I suppose...how was your experience with getting it all submitted and the consult with the surgeon?

Hadassah · June 20, 2008

Congratulations, I know what that means! it is the begining of a new journey in your life.

I am still waiting for my insurance to be approved.

clayverde · June 20, 2008

Hey - I have Tricare too (Triwest and I'm Tricare prime b/c hubby is active duty Navy) and Tricare was the BEST!!! I almost hate to even put this here given how much hassle and heartbreak so many other people have gone through with their insurances, BUT Tricare was a breeze. I didn't have to have any kind of waiting time and diet/nutritionist appts. etc. before they'd approve it. I had every appointment immediately paid for with no copay or deductible. The only thing Tricare actually required was an EKG (which was also covered) and then once the package was submitted (on a Thursday) I was approved by MONDAY! The hospital told me that the normal time waiting on insurance approval was six to eight weeks. So four days is incredible. In the original meaning of the word - defying all credibility!!! So right after that I had my appointment with the surgeon and then scheduled my surgery which is only 30 days away!! So thank your lucky stars if you have Tricare. Of course to have it we've had to deal with being a military family but there's no free lunch, right?? Anyway, good luck!:smile:

zeama · June 20, 2008

Congratulations!!! I also have Tricare and found that it was very easy to get everything approved!:smile:

Long2BFree · June 21, 2008

Thanks everyone for the well wishes. The support here is incredible.

Altoonasoup - I'm sorry for the disappointment you have had to deal with in trying to get your insurance to approve your surgery. I just learned in February of this year that my insurance started covering the procedure. Have you checked your policy for the 2008 year to see if they are now doing it before you start the process again? I hope things work out in your favor.

Aculberg - My surgeon required lots of steps before he would even see me to discuss the surgery. Once all of his guidelines where fulfilled then I got in to see him to discuss the surgery at which point he looked over my records and medical tests and decided it was a go. His office then submitted the paperwork for a pre-authorization. I understand that Tricare doesn't require everything that some surgeons require.

I even received a phone call from a nurse at the Tricare office this morning to tell me I was approved but I already knew that because I checked my profile on the website. She then asked me if I understood what the surgery involved, if the surgeon explained the post-op care procedures and the date of my surgery. She said they would be calling me again a couple of days after my surgery to do a follow-up.

Clayverde - Congrats on getting your approval and your upcoming surgery! It looks to me that Tricare is one of the better insurances as far as getting quick approvals.

Choromom · June 21, 2008

I've actually had Tricare approve surgery for me twice! My husband retired during the process, so it had to be submitted again, and now I have the deductable and co-pay, but I'm still impressed with how quickly Tricare processed this.

And the caseworker...mine is named Karen, I have her direct line, I've called her 3 or 4 times and have never waited more than two hours to hear back from her, and she has made calls to the surgeon's office in my behalf.

I'm scheduled for pre-op on July 11, and surgery on July 22.

Tricare does have its drawbacks, as was mentioned! We live the military life style, and some facilities don't like it because it doesn't pay as much as other insurances. But the way they take care of their members is impressive.

eazes · June 21, 2008

My surgeon was actually happy when I told him I had tricare as insurance. His exact words were..."Tricare oh then this will be easy then!" I'm so happy that tricare can make it easy when it comes to getting approved for referrals. Now if only it could be so easy to get an appointment on base to see you PCM. LOL