need help..again..tricare...PCM

[katwmn63 0]

christinaw-

254-282 is your new "range" for meeting te 200% for Tricare. At 275 you are considered within the 200% range (i spoke to Tricare about this because I was using their 100 lbs over w/2 comorbids requirements and fell in the middle of the range myself) They will also likely approve you without comorbids since you meet the 200% requirement. Also...just as an fyi - TRicare seems to approve it quickly if sleep apnea is present. have you ever had a sleep study? Many of us have it without even knowing it due to our weight. Tricare covers sleep studies.

Good luck to you!!

Edited July 4, 2009 by katwmn63

[Tina254 0]

I was so worried about fitting in the range for tricare, thank you for clariflying that because I thought you had to fit the highest ideal weight they have on the metlife chart (I thought I had to be at 282) I'm glad it's the range between 254 and 282, because me being at 275 fits me in the high middle :eek: Now I feel so much better and have a more positive out look on getting approved. I am hoping I get approved on the 200% over if I can't get the testing for the sleep apena before my initial consult on the 14th.

I never have had a sleep study done but I will definantly look into that now so that it can be done before I go to in inital consult with the surgeon on the 14th of July.

How do you go for a sleep study, do you have to see you PCP to get a referrel for the sleep sutdy? Is there a long wait?

Good luck to you as well, I see your sugery date is the day before my consult!!! I'm excited for you, I hope I can be in your spot too soon! Thanks again for all your help and everyone else. :smile2:

Edited July 4, 2009 by chrystinaw

[katwmn63 0]

chrystinaw-

if you have tricare prime, you will need to get it (sleep study) approved, but if you have tricare standard you can go have the study without a tricare referral or approval.

-kat

[Tina254 0]

Does any one know what this means?:thumbup:...On the triwest website it says I'm approved for two things my consult with my surgeon (1 visit) and "office/outpatient visit (3 visits)". I know what the consult means [because I've already been at my first consult] but what is the "office/outpatient visit, is that the surgery? I'm planing on calling later today when they open to ask tricare but I'm confused and I don't want to get myself excited if its not the surgery so I'm keeping myself composed until I call or get an answer from anybody on here. If anyone knows please please let me know! Thanks

[Lilpeach_059 0]

when the surgery is approved it will say something like....approved one visit lap or gastric band placemen. if you look up my posts you will find where i posted exactly how tricare words it. i would find it and post it here but im on my cell. hope this helps and good luck!

[Lilpeach_059 0]

ok, i went back and found it....its something along the lines of

i

lap place gastr adj device

hospital

doctor

date submitted

date approved

outpatient bariatric surgery

they approved me in about three hrs so hopefully u will get yours really soon!