Have you been approved through Tricare with the same stats as me?

[talkalot1981 5]

I am waiting till June 3rd to see the surgeon, but I know tricare can be very picky about the weight and such. I am 5'4" 239 lbs I have 1 co morbity Hypertention. And I have been over weight for my whole teen and adult life. I have found many different hight and weight charts and everyone seems to be different. If anyone has any info just let me know. Thanks Jennifer

[ParrotheadCathy 0]

5'4" and 239 pounds is a BMI of 41.1. Most insurance companies that cover weight loss surgeries look for a BMI of 40 without co-morbidities. The only limitation that could be a problem, is some insurance policies require that you be at a specific BMI for a period of 36 months.

[bugginbri 0]

I have Tricare as well. I am 5'4" and was 246 lbs at the time of my consult. I had no co-morbidities but have a huge family history of diabetes and also had gestational diabetes with my last pregnancy. My BMI was 42. I was approved very quickly and had very few pre-op tests or requirements.

To get a BMI chart online I did a google search and found one I could print. I keep it on my desk as a reference so I can keep up with my progress.

Good luck!

[talkalot1981 5]

Cathy- Tricare only goes by the 100lbs over weight rule. They don't care what the BMI is. And they use the highest side of the weight chart. I gained 4 lbs so I would qualify. I know it sounds bad but it is not like it is 20. being 5'4" and 27 yo I should be 125-136. So now that I am 239 lbs I am just trying to maintain my weight, I am affraid to fall below that 100 lb mark since I am so close.

[charms 1]

I have Tricare also.

I am 5'1" - 220 lbs, with type II diabetes, I got my referal from my PCM on 04/15/2009. Saw the surgeon on 04/24/09. Got the medically necessary letter from the PCM to the surgeon on 04/29/09. Got my approval on 04/30/09 and was banded on 05/12/09.

Tricare is very quick if the letter say's the right things. They will also call you as soon as the approval occurs. You will know before the surgeon.

Tricare has two rules, either you are 100 lbs over weight or you have a morbidity factor and fall into the obese category of the BMI.

Edited May 17, 2009 by charms

[wintobethin 5]

I too am tricare and I am 5'4" 237, and was accepted at the base in Dayton. Only needed Psych, dietician, ekg, blood and that was it! Banded Jan 16, 2009, have lost 34lbs so far............