Tricare Prime and Lap Band

[MrsMoretti 0]

Hello Everyone, I have Tri Care Prime. This is what my journey so far has been like. I had to go to my PCM to get a referral to see a surgeon , So I got my referral I called to make an Apt with the surgeon and I found out that I had to attend a Free seminar first before I could schedule an Apt with the surgeon. So I went to the free Seminar and while I was there the bariatric coordinator told me that she was going to get the process started for me and she told me what I needed to do from there on out so what I had to do was make 3 Apts with other Dr.’s that Tri Care requires you to go to which were 1. See a Bariatric Dr. he basically just asks you about your history and your health 2. I met with a nutritionist basically she just ask me what my eating habits are and told me a little bit about how its going to change with the Lap Band DUHHH no kidding its going to change right ?? LOL ….. Thinks that’s why we are all looking to get the surgery because we need a change in our lifestyle 3. Was a Phyc Apt. Just making sure your really ready for this lifestyle change and making sure that you will be able to handle it. Then after all 3 Apts you schedule your Apt with your surgeon. I met with him he did some paper work told me that I am boarder line where im supposed to be for tri care to approve me I’m 5’5 235.6 when I got weighed in at his office. Going by what everyone else says that Tri Care uses the Met- Life weight chart (med frame) which says you should weigh 127-141 for my height So that should put me at 200% over my ideal weight Im PRAYING that I get approved …. So I’m all done with my appointments with Dr’s but I still need to attend a class where they tell you all about how your lifestyle and eating habits will change after surgery I heard that this class is mandatory in getting approved for surgery . So I will be attending that class May 10^th 2011 , after that my bariatric coordinator is going to submit all my paper work to tri care and hope I get approved….. If anyone else is around the same height and weight as me and got approved or has a similar story and didn’t get approved please let me know. I also have a bad back and joint pain along with anxiety I don’t know if that will really help my case much, Please reply and give me any input you may have and I hope I was helpful for any of you who are just getting started in the process . Oh also Since I was boarder line where I was supposed to be my bariatric coordinator told me that I should get a support letter from my PCM saying that I have tried other weight loss diets and didn’t have success and that I have a bad back and anxiety and he thinks that by me having the surgery it will help with weight loss and will help with my back pain…. My bariatric coordinator told me that having a support letter it will only look better for you getting approved … I also had to get an EKG and chest X-ray done before my PCM would write the letter he wanted to make sure I was healthy enough for surgery ! …. So that’s all so far hope I helped maybe you all can help me and let me know what ur process was like

Thanks

[Jaclyn9 0]

Hey all! I have a question. I am just starting the process and my doctor will be sending over the referral/request tomorrow, but does anyone know how the process works for Tricare Standard? I know I still need an approval because its not generally covered but I am very nervous hoping this goes through. I am currently 230lbs... at 5'1 an ideal weight for me in 140lbs ( personally) but on a height/ weight chart I should be about 115. I have been working on this for some time myself and in the gym and getting no where. I think I was definitely at my breaking point and my doctor has been suggesting this for awhile. Any thoughts?

[AlmaD 9]

Hello everyone I'm a newbie on here and much like everyone else I have a few questions ..I see on here that u have to be 100lbs over your ideal weight or more with obesity conditions to get approved by tricare prime. Ok I looked at the metlife chart and it only goes ul to 4'10 :/ I'm 4'9 and I weigh 183 but I do have sleep apnea and a fatty liver and high cholesterol ..do you all think Tricare lrime will approve me?