Question:
Can anyone tell me about Tricare Prime (military insurance) I have not

I have not received the denial notice yet, but I called Tricare, and for the last two weeks to find out about the descion for the WLS, all I got was that it was still pending, and finally last Tue. the lady looked into the computer and said it was not approved. I have to wait until I get the letter but I am so close, my BMI is 39. but I am not 100lbs overweight. I do have comorbities.Snoring, bad knees, back pain, urinary problems, family history of morbid obesity, on both sides (mom, and dad), family history of stroke, diabetes, highblood pressure, heart triple bypass. Anyone know anybody who had to go through the appeal process? I have my letter all ready typed up. In the meantime I have gained 10lbs and now I am closer to 100lbs. I have letters from my PCP who says I have tried everything (presc. diet pills, fad diets, and I have exhauseted every mean of diets. But I guess I need to wait for the letter to come. I need some support from someone who had to go through this process with Tricare. (Active duty Prime).I would of thought Tricare would approve my surgery since my weight only is rising. I just don't know what to do. Please email me for suggestions. [email protected].    — Tina B. (posted on March 23, 2002)

March 23, 2002
Tina, Wait for your denial letter and go back in and have your PCM reweigh you and resubmit. Is there any possibility you can go to a military installation and have the surgery? Tricare is very stringent with the 100 pound rule and BMI of 40. I had my surgery at Wilford Hall Medical Center (WHMC) in San Antonio, TX and they were doing WLS on some with BMI's of 38 and 39. Feel free to email me if you have any additional questions: [email protected] Ciao, Victoria in Italy :) PS--I know Lisa Boone...she is no longer a military dependent.
   — perezrdh

March 23, 2002
PS--I forgot to mention if there is a military base/post within a reasonable distance, Tricare will deny WLS. Many don't wish to be on long waiting lists so they ask to be referred to a civilian doctor. Valerie may have been denied since Madigan in Tacoma, Washington does WLS. They have a fairly long waiting list. Hang in there all. Ciao
   — perezrdh

March 24, 2002
Its me, I don't think I mentioned there are three ladies who were approved who had WLS, and have Two have tricare standard, and the other has Tricare Prime. We have to be refered out. We are stationed at Fort Leonard Wood and they don't have a surgeon to do the surgery.
   — Tina B.

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