Getting The Lapband Done With Tricareprime

[kaitlynmarie93 0]

My family has tricare prime because my dad is retired military, I was wondering; every who has had the surgery done with tricare prime, what was required for your approval? I was also wondering how long it took for some of you to actually get a surgery date.

Were you required to do the 6 month diet? :laugh:

[RestlessMonkey 7]

I'm tricare standard and because I was so heavy, approval took 2 days. There is an insurance specialist at the hospital where I had my surgery done and she (bless you Nadia) filed everything.

You might find more info under the "insurance" forum. WIth tricare, speed depends on how heavy you are, and then if your BMI is 35-40, what comorbidities you have. I didn't have to do a 6-month diet but don't know if that was because I'm tricare standard, or because how heavy I was to start, or if it's because tricare doesn't require it.

Tricare has a web site that may give you more info, too.

[orrn 0]

Hello I am Tricare Prime in San Antonio. Never know how long it will take for someone to get thru the process cause each case is different...First things is just to have your pcp put you in for a referral for lap banding. Then the military will have a choice to take you in their facility or can contract you out. Then whom ever will get the referral followup is what you will have to go by..Good luck. I'm scheduled for LB on 3-26-09!!!:laugh:

[Hel 0]

Hello, I am Tricare Prime in NM. I got a referral from my PC Dr. late January, my 1st appt with the surgeon 2/27. I need a psych eval, then the EKG, labs etc- once they are done I get a surgery date. The surgeon's office said Tricare determined I had no 'criteria', no 6-month diet, no waiting period. I think it really depends on your individual situation- weight, co-morbidities etc.

I want to add something here which may or may not apply to you. My prior PC Dr (we live in an Air Force town, I go to the AF clinic- but my husband isn't AF) told me I had to do the 6 month diet and the nutritionist appointments. My husband (who does health benefits admin among other things) said that was an Air Force requirement, not a Tricare requirement. Then my PC Dr. moved on, it was a new Dr. I saw in late January, who gave me the referral without any trouble.

It really is very individual, but let us know how it works out for you. Good luck!

Edited March 8, 2009 by Hel
spelling!

[tharris48 0]

Hi, I am retired military myself and use Tricare Prime. I just got banded 2-25-09 at Portsmouth naval Hospital. I started the process last spring with a visit to my PCM and I had to have 6 months of documented nutritional guidance (i.e. WeightWatchers) or some sort of documented weight loss attempt with a nutritionist, which is what i did. I met the BMI requirement of 40 and had no co-morbitities. It took almost a year (10 months) for my particlular case because my surgeon got deployed and i had to wait for his replacement. I can only speak for Portsmouth Naval Hospital and they have done a wonderful job taking care of me through the process.

[Rdy4ANewLife 3]

Hello, my husband is Active Duty Air Force, so we have Tricare Prime. I went to my PCP and she sent a referral to a surgeon and all that was required for me was a Psych Eval. I didn't have to do a 6 month diet or anything. They filed everything with Tricare and I was approved 2 days later. My surgery is March 16th. =D Good luck to you and God Bless!

[topless muffin 0]

Tricare itself does not require a 6 month supervised weight loss. If your doctor is telling you that it does, he's wrong or he's the one that's requiring it.

[Allformyson 0]

Hi. I have TCP (in the northeast) and it has taken about 4 months to get from my initial appt with my PCP to my initial appt with the surgeon (next week). The time was mostly due to the wait time to get appts.

As far as tests/consults, tricare requires the following:

Cardiac clearance (EKG)

Blood work (tyroid and another one I don't remember)

Nutrition consultation

Psych consultation

Letter from your PCP with medical history

I have a feeling that I'm forgetting something though....

Good luck

[mljalways 1]

Tricare worked fast for me!! I had approval in about 3 days. No 6 month diet required. Type II diabetes and high blood pressure helped me get in.

[Mello Mel 0]

Hi, I called Tricare and they said I wasn't eligible, as my BMI is only 35.4, 65 pounds over weight and I don't have diabetes or high bp. I do have other things like sleep apnea and GERD. Any advice?

[RestlessMonkey 7]

Hi, I called Tricare and they said I wasn't eligible, as my BMI is only 35.4, 65 pounds over weight and I don't have diabetes or high bp. I do have other things like sleep apnea and GERD. Any advice?

I'd think your only option would be to pay for the surgery yourself.