Question:
Does Tricare Prime pay for tummy tuck after having gastric bypass surgery.

I am at Ft. Stewart,Ga. I am at a steady weight and would like to have a tummy tuck to remive all this excess skin. I have heard that Tricare does pay. I want to know what procedures I need to go through. I look forward to your help. Barbara    — bjdp1495 (posted on March 15, 2006)

March 15, 2006
Hi Barbara, Tricare will generally cover a tummy tuck if there are medical conditions that are present, a hernia or severe skin problems. Michelle
   — mchrane

March 15, 2006
Hi Barbara, Tricare WILL pay, but there are procedures you have to follow. For one thing,you have to make them see it as "reconstructive" instead of "cosmetic." To do that, go to your PCM and document your troubles with rashes, chafing back pain from the excess, etc. This is very important, and start it as soon as possible. It has to be considered a surgery to improve your health, not just your self esteem or looks. I did a lot of research on this just a couple of months ago, and I found where it specifically states in the policy, that this is a covered benefit under certain conditions. This statement used to be available on the web to the public but is now only found within their system. I found a wonderfully sympathetic benefits adviser/nurse who printed this out for me. If you'd like a copy, send me your email address and I'lls end it over to you. Having it in hand and knowing the circumstances under which it is covered will help bothyou and your PCM. My PCM swore to me that there was no way on earth that they'd cover it and that he wouldn't bother wasting his time writing me a referral for it unless I talked to those benefits advisors and could prove to him that it was covered. So that's what I did. Now I've proved him wrong AND I can take this to him and tell him exactly what he has to write in order to get the referral. This statement specifically says that it's covered for those who have lost a lot of weight through surgery or other means and have other specific problems. Hope that helps! Christie
   — christied