Copays?? Noway!!!!

[ArmyWife 0]

OK, I am TriCare Prime South, going to a civilian doctor, my hubby is in the army, active duty, deployed, been in the army for about 8 years now. I am coming to ask some of you ladies who have been through this process all ready with Tricare something...

Have you had to pay different copays along the way? So far I am in the pre op testing and I have to pay $60 for the PSYCH eval, and $18 for the NURTITION eval. Does that sound NORMAL to anyone? When I go to normal doc visits or anywhere else(even when I had to go to the emergency room) I've never had to pay anything. B/c I am new to this I guess I don't get it. The patient advocate who is working with me explained that Tricare doesn't cover it, but reading through some of the threads I saw that some of you had to pay some copays and others didn't. I am not understanding why I am having to pay for this stuff when this stuff is supposed to be covered. Am I tripping or is this normal? Can someone PLEASE bring it into proper perspective for me, b/c I just don't get it.

[thatDEgirl 1]

I am 7 weeks post-op and have not had to pay a cent (civ surgeon and hospital). I am also Tricare Prime South. I had my nutritional eval with the base nutritionist, so no fee there and found a pysch to do the pysch eval through Value Choice (who Tricare uses for mental health care). I found out after the fact that I could have had the pysch eval done on base but it didn;t cost me anything, so I didn't care.

[ArmyWife 0]

OK, so we can find our own Psyc and possibly not have to pay for it then? She did tell me that I could find my own , but never said anything about the pay for it. Hmmm, I am thinking that I may find my own. $60 is a bit much I think.

[JamieNP 20]

Tricare has paid everything so far except the Nutrition class. I had to pay that up front and they submitted it to insurance...haven't heard if they covered it yet.

I have Tricare North Prime.

[MrsEOD_2004 0]

I'm Prime South as well and have never paid anything for any visit. S&W has psych's they like you to talk to (they give you their card at the seminar), and Tricare covered it. I didn't have to do a nutriution class though.

[ArmyWife 0]

Congrats on your surgey JWRN! I look forward to my surgery date as well. If you don't mind me asking...how much did you have to pay for the nutrition class?

MrsEOD, how is it that we have the same insurance, and are at the same Surgeon, but you get a better deal than me? lol...what's your secret...DO tell...lol! Did you choose their Psych or did you choose your own. In other words, did they set everything up for you?

Edited September 13, 2008 by ArmyWife

[ArmyWife 0]

OK, I am TriCare Prime South, going to a civilian doctor, my hubby is in the army, active duty, deployed, been in the army for about 8 years now. I am coming to ask some of you ladies who have been through this process all ready with Tricare something...

Have you had to pay different copays along the way? So far I am in the pre op testing and I have to pay $60 for the PSYCH eval, and $18 for the NURTITION eval. Does that sound NORMAL to anyone? When I go to normal doc visits or anywhere else(even when I had to go to the emergency room) I've never had to pay anything. B/c I am new to this I guess I don't get it. The patient advocate who is working with me explained that Tricare doesn't cover it, but reading through some of the threads I saw that some of you had to pay some copays and others didn't. I am not understanding why I am having to pay for this stuff when this stuff is supposed to be covered. Am I tripping or is this normal? Can someone PLEASE bring it into proper perspective for me, b/c I just don't get it.

Oops...I said $60 for PSYCH exam and it's actually for the EXERCISE exam. I mistyped that in my initial exam. I spoke with TriCare directly today and they told me that most people don't have an exercise exam so it's not covered. As for the nutrition exam, he said when he typed it into the computer, it didn't come up as well, so it also wasn't covered. But still I know some people had a nutrition eval and didn't have a copay. I don't know, I will pray over it and see what God guides me to do in all of this. Maybe I can lose weight on my own. $60 and $18 isn't much, but it's the principle for me.

[gina s. 0]

I have Tricare Prime South too, and I went to Scott and White. I haven't had to pay a co-pay for anything.

[proudestmomof2 0]

Fort Hood also!! Ahhhh is this going to be as hard as I think it is??

Thanks

Venus

[gina s. 0]

Fort Hood also!! Ahhhh is this going to be as hard as I think it is??

Thanks

Venus

I hope you don't have a hard time. For me, everything was extremely easy except for the time spent waiting between appointments.

[ArmyWife 0]

I have Tricare Prime South too, and I went to Scott and White. I haven't had to pay a co-pay for anything.

Yeah it sounds like Scott and White is the place to go...I am having mine done in Austin at SW Bariatrics, maybe I should change it to Scott and White...things for me were pretty easy too...well, no that's a lie...the easiest part for me was TriCare approving me, to be honest. Dealing with SW Bariatrics has been a lot of work. It's like I have to follow behind them to make sure that I get my surgery done and they don't forget about me, which I think is utterly ridiculous! And like I said in another post, I had no clue that being in Killeen, we had an option to have the LapBand done in Temple, which is WAAAY closer. My doctor automatically referred me to Austin--an hour away. How often will we be getting fills? Won't that be hard on me with gas?? I feel so shafted in this whole process I just want to shut it down and start all over again...maybe these are all signs from God...LOL!!

Edited September 18, 2008 by ArmyWife

[proudestmomof2 0]

Well I got the guts up to call TRICARE!!WoooHooo

They approved the referral!

One step down!!

I guess the next step is a siminar at Scott and White????

I am so excited!

Does this mean that I can have the surgery or that there is still a chance they can say no??

[JamieNP 20]

No this means your referal is ok. Doesn't mean surgery is approved...yet. I got referal approved but surgery was denied.

[gina s. 0]

My doctor automatically referred me to Austin--an hour away. How often will we be getting fills? Won't that be hard on me with gas??

I don't know about at SW, but at Scott and White I go for fills every two-three weeks. I don't know why your doctor automatically referred you there, mine gave me three choices: I could go to San Antonio and have it done on base, I could go to SW in Austin, or I could go to Scott and White in Temple.

Proudestmom, you could go ahead and start scheduling your psych eval. If you are going through Scott and White, they recommend using the Chupik Counseling Center. There is an office here in Killeen, you can self-refer. All I did was call them and explain that I needed a psych eval for WLS, and they took care of getting the insurance approved and everything. Let me know if you want their number, good luck!

[ArmyWife 0]

I don't know about at SW, but at Scott and White I go for fills every two-three weeks. I don't know why your doctor automatically referred you there, mine gave me three choices: I could go to San Antonio and have it done on base, I could go to SW in Austin, or I could go to Scott and White in Temple.

Who is your PCP with? Mine is with Kings Daughters Clinic. Are you with Scott and White? Maybe that's why she didn't suggest Scott and White for a "conflict of interest" ?

I am going to ask if this can be changed, b/c going to get fills every 2 weeks and having to drive an hour to do them, doesn't that seem a bit excessive? I mean, do y'all think I am being overly concerned about the drive and the copays too much? I just don't want to be hoodwinked is all. I know the surgery is probably worth it in the long run, but driving an hour every 2 weeks, with the way gas is...that seems like a lot to me. I am still going forth with the surgery, but I am almost favored to starting the process all over again JUST to go through Scott and White if it means that I will be closer to home and won't have to pay all these copays.

Edited September 19, 2008 by ArmyWife