Tricare Approval or Denial??

[KarinaM 0]

Any news, Meggie?

[Vala 0]

My mother has Tricare and is hoping to be banded ASAP.

She is 62 years old, 130 pounds overweight and has type II diabetes, bad knees, high cholesterol, sleep apnea and severe back problems (her back surgeon told her she should never weigh more than 120 because it is so bad).

Do you guys think she will be able to get through the system without too much problem? She is so excited at the prospect of losing weight and getting healthier. She told me that she has been having dreams about being able to get out and enjoy life again. I think we will both be heartbroken if she is not approved.

We are going to the seminar on October 21st.

[KOLaficionado 0]

Wow, this thread is great. I've learned more with reading it for 20 minutes than I've gathered for the last month elsewhere:) I do have a couple of concerns. I just registered with Tri-care and picked my doctors this week. I have not had health insurance since I was pregnant 2 years ago. Does anyone know if there will be any kind of a waiting period? Kinda feels wrong to sign up for the insurance one week and request a 15000 dollar operation the next week..But don't get me wrong, I'll do it! I don't think I'll have a problem getting approved. I'm 5'5 and 260 lbs and have high blood pressure and cholesterol and I think sleep apnea. So I guess my first step is to get some meds!

[mljalways 1]

Newnavywife..........where are you stationed?

[KOLaficionado 0]

Nowhere yet, we're in the DFW area. My husband just got accepted into the nupoc program. He is active, but his orders right now are to finish his degree. It's a sweet deal really. I'm not looking forward to the time apart later, he'll be on a submarine for months at a time. But other wives have endured it and I'm sure I'll be able to as well. We'll be in Charleston when he graduates though. It looks like your due to get your surgery soon, Congrats!! I hope my submission and approval goes as quick as yours, I don't mind waiting, but who wants to??!

[KarinaM 0]

My mother has Tricare and is hoping to be banded ASAP.

She is 62 years old, 130 pounds overweight and has type II diabetes, bad knees, high cholesterol, sleep apnea and severe back problems (her back surgeon told her she should never weigh more than 120 because it is so bad).

Do you guys think she will be able to get through the system without too much problem? She is so excited at the prospect of losing weight and getting healthier. She told me that she has been having dreams about being able to get out and enjoy life again. I think we will both be heartbroken if she is not approved.

We are going to the seminar on October 21st.

I'm sure she will have NO problems on getting approved as long as she gets all her tests done (pscy eval, nutricionist, PCM letter and sleep study). Besides the nutricionist eval she should be getting all paid by Tricare.

[Jewlo 0]

Hi there.. I am too nervous that I won't get approved also. Although TriCare (Prime) approved 4 doctors visits. My PCM has filled out the Letter of Medical Necessity Paperwork, Clearance for Surgery and Blood Work. I go see the Bariatric Surgeon on Monday. I am hoping that everything will go smoothly !!! My BMI is 39-40 with a history of hypertension, high cholesterol and lower back pain. Just wish me luck for MONDAY !!

[JamieNP 20]

Hi there.. I am too nervous that I won't get approved also. Although TriCare (Prime) approved 4 doctors visits. My PCM has filled out the Letter of Medical Necessity Paperwork, Clearance for Surgery and Blood Work. I go see the Bariatric Surgeon on Monday. I am hoping that everything will go smoothly !!! My BMI is 39-40 with a history of hypertension, high cholesterol and lower back pain. Just wish me luck for MONDAY !!

You should have no problem getting approved if you are 100 lbs overweight according to the metlife table. Tricare could care less what your BMI is..my surgeon's office had a long discussion with a Tricare prime representative about it.

[gina s. 0]

You should have no problem getting approved if you are 100 lbs overweight according to the metlife table. Tricare could care less what your BMI is..my surgeon's office had a long discussion with a Tricare prime representative about it.

That's what I was told also....BMI doesn't matter. It's strictly case by case as long as you have the 100 extra pounds and a health problem that will be improved by loosing weight.

[Jewlo 0]

Everything has been going through pretty fast just waiting on Pscyhology now and 2 more classes. I should know by thursday !!:thumbup:

[NavyWife84 0]

I was told by tricare that they don't cover nutritionist so why is it a requirement to qualify

i'm not quite sure what all the requirements are????

[mljalways 1]

I was told they dont cover it becuase you can use the health and wellness center at any MTF

[NavyWife84 0]

oh I see........that sucks I don't live anywhere near a base right now

[mljalways 1]

Yeah it does suck, I got lucky I guess. Having tricare is ahrd enough! I couldnt find a physchologist who took it so I was able to have that done on base too.

[KOLaficionado 0]

Yeah it does suck, I got lucky I guess. Having tricare is ahrd enough! I couldnt find a physchologist who took it so I was able to have that done on base too.

That is good to know, I haven't been able to find a physchologist either, but hopefully can use the one at Carswell. Congratulations:thumbup: on the surgery date!!