MrsB912 0 Posted August 27, 2008 Hi everyone! I'm new here. I just stumbled across this site while Googling to find out if Tricare covers the Lap Band. I am just trying to find information and then maybe see if I will be covered for it. I don't think I will but I am interested in it. My name is Nikki and I'm almost 21 years old. I live in Okinawa, Japan with my husband who is in the Air Force. I've been overweight my entire life and really want to lose weight so I can live a healthier life and so that we can start our family. Have a great day! Share this post Link to post Share on other sites
RestlessMonkey 7 Posted August 27, 2008 Yes tricare covers it subject to conditions. I'm not sure exactly what they are; but if you're active duty, wouldn't you go to a base hospital? I'm tricare standard and weigh enough that comorbidities etc weren't an option. They submitted my packet and 2 days later it was approved. Share this post Link to post Share on other sites
MrsB912 0 Posted August 27, 2008 My husband is AD and I'm on Tricare Prime. We are overseas so if I were to be approved, I would be sent to Hawaii for the surgery. I don't have any health problems besides my weight. I'm almost 21 and I'm 5'5" (maybe 5'4") and 240-245lbs. I read that the Tricare requires you to be 100lbs overweight (which I am) and have a health condition (which I don't have). I have never talked to my doctor about it. Last time we talked, he said to get a personal trainer and go on a diet. He said if I didn't lose weight to come back and see him. So I might try to lose this on my own and if I can't then I'd go back and talk to him about my options. I just hate working out and not seeing results. Share this post Link to post Share on other sites
RestlessMonkey 7 Posted August 27, 2008 You can enter tricare in the search bar. I had no trouble but if they say 100 pounds and comorbidities, they won't approve you unless you have them. I've read many who were turned down...or they had the comorbidity like diabetes but only were 96 pounds over and were rejected. i heard (all this is hearsay, not personal experience, remember) that tricare uses the "medium frame" from the metlife ins table to see if you are 100 over or not. Share this post Link to post Share on other sites
HF2008 0 Posted August 27, 2008 After getting a referral from your PCM... Tricare Prime will pay a consultation with a surgeon, then the surgeons office will send in your requests for approval for the surgery. I am Tricare and I had mine on 06/02/08, and have looked at my claims, and it's all taken care of... You don't have to have co morbitites because I had none. I was just 100 lbs over weight. When you chose the office you want to work with all you have to do is be completely honest on the questionaire, and that's where your comorbitities come from, believe it or not. The surgeons office you work with to get the lapband wants you get to approved so they will work with you on getting that approval. You see normally they know what each insurance policy calls for to get approval ...Good luck! Share this post Link to post Share on other sites
RestlessMonkey 7 Posted August 27, 2008 Very lucky HF! I've read some real horror stories about ins (both tricare and others) I didn't have any trouble but my BMI was so high the rest just wasn't an issue. Share this post Link to post Share on other sites
HF2008 0 Posted August 27, 2008 Yeah my journey was really simple....I thought about getting it and I woke up banded...LOL! My BMI was 41.2 Share this post Link to post Share on other sites
