San Diego TRI CARE HELP!

Ok so my PCM put in my referral today and it got approved the same day with tricare BUT it was approved with Modifications.  Instead of the surgeon I picked, that is in network, they are sending me to Balboa.  I called tricare and asked why they switched it and they said it has to go through the military first and yada yada and that if I want to try and change it that I can contact Balboa and basically plead my case.  This is bittersweet for me.  When I finally made the decision to do this, I decided I only wanted the BEST DOCTOR THE BEST CARE THE BEST HOSPITAL.  Dr. Owen is a top rated surgeon and Alvarado hospital haas an entire Bariatric floor that has the large size beds, large chairs and people trained to care for larger patients.  I DO NOT want to have it done at BALBOA.  First of all we all know that getting anything done at a mtf takes FOREVER.  And I do not to have a different doctor each time.  So my question to you is, has this happened to any of you ladies?  And if so how did you convince them to allow you to go to your civilian surgeon, and how long did it take?  Thanks so much ladies!

Hi,  Same thing happened to me last year this time, I requested a referral but it was intercepted and I was approved for surgery at Balboa, nad not with Dr. Owens.  I started the process with Dr. Owens and I was already familiar with him and his staff, and I just wasn't interested in doing this all over again with the staff at Balboa.  Because you're Tricare Standard, they're going to send you to Balboa and I highly doubt they will send you anywhere else because they are able to provide the service you are requesting.  Believe me I tried.  I just switched to Standard, went back to my PCM had them redo my referral and I had surgery a month later with Dr. Owens.  Total out of pocket was about $60.   Balboa's bariactric program is actually very good, I went through some of the process, you work with only one person Annelise Brown she's an NP and there are only 2 doctors that perform the surgery.  First you meet with her and she will go over what types of procedures and tests you will need to have pre-op and the classes you will need to take, if you're on top of it, you can be scheduled for surgery in a month or so.  It really is a good program and very organized.  But like I said I had already started with Dr. Owens and wasn't interested in switching.  But Balboas program is definitely not a bad one, if you must go there.    If you're interested i hvae some links to their online support group. Hope it works out for you the way you like!!! ~April

April I would love to talk to you more about this.  I actually have TRicare PRIME not standard, not sure if that makes a difference....