Tricare and fills

[cobrien78 0]

OK so I had to call tricare to see if I could have my pre-op testing at the hospital where I'm getting my surgery or have it at the base and I asked the lady if tricare covers the fills and I think she was confused and didn't know what those were, she told me it covers only up to 6 weeks after my surgery?!

So does tricare cover fills? If so who do I call to ask and get this clarified? I have TriWest Prime in case that helps.

[obgray 0]

TRICARE has covered all of my fills. I had 6 visits on my initial authorization, and then I just had to have my PCM put in another referral for more visits. Got 6 more visits.

[cobrien78 0]

So will tricare send me paperwork about my approval for surgery? Will it be in the paperwork?:confused2:

[MaggiesMom1999 0]

My surgeon's office told me that Tricare does NOT cover fills and I had to prepay for 6 of them prior to the surgery.

[Mimilou2004 13]

Now this is frustrating to read, one Tricare will and one won't? Now I don't know if mine are covered!!! Guess I will call. Answer was no, not covered in the initial price, each fill is billed as a separate event for my situation.

Edited August 21, 2008 by Mimilou2004

[Mimilou2004 13]

So will tricare send me paperwork about my approval for surgery? Will it be in the paperwork?:confused2:

Tricare told me on the phone it was approved, never got anything in the mail. I have Tricare Standard and my Doc is out of Network so I am paying a large co-pay and %. Plus, my preop stuff will be in one fiscal year and my surgery (Oct 7) in another fiscal year so I am not even maxing out to get any free care. Oh, well, better than paying for it all on my own.

Mimi

[tomatogirl 0]

Do you have TriCare prime or standard? They are really 2 different animals. here is some more discussion on the subject: http://www.lapbandtalk.com/f13/tricare-prime-ins-coverage-67402/

My understanding is that with Prime, they will give you 6 referrals for your doctor for which you can use for fills and whatnot and after you run out, you can ask your PCM for more referrals.

[Mimilou2004 13]

I have Standard Tricare. Thanks for the click on thread, I should have paid for Prime Tricare before I started this journey!!!!

Mimi

[cobrien78 0]

Ok I'm bumping this up to ask how or where can I find the information that Tricare Prime will cover my fills after surgery? Because when I called and asked before the lady obviously didn't know what I was talking about and said the authorization only covered 6 weeks after surgery. Can someone help?:confused2:

[cobrien78 0]

Ok I got the answer! My dr. has to submit authorization for more office visits with correct CPT codes for tricare to cover fills around the time of my surgery. Whew! Hopefully that goes smoothly!