Anyone have Tricare Prime and is seeing dr.bell for the surgery

HELP!!! Hi Everyone, I am so confused and depressed. I am at the end of all that is required of me to get an apt. to see Dr. Bell. I'm just waiting for the faxes with the nutrisionist and physcologist. Well, friday I called Liz to see if she had received them and she said no not yet, so I called and they both said they will fax them again. I waited and called Liz back. She just told me that Tricare is NO LONGER AUTHORIZING LAP surgery. She said that I might want to hold off on the faxes that one of the ladies are trying to look into it and that she has 12 people on hold as well because of this.. Help..... I have a few friends that have had Dr. Bell do Lap and they are both Prime, why did they change this and is it a rumor? I called Tricare on Friday and they 2 of the people said it is a rumor and to go by the handbook and in the handbook it says it is covered and nothing about just OPEN in covered.... WHO IS WAITING ON THIS... AND WHO IS GETTING READY TO SEE DR.BELL? Tara

Hi Tara, From what Liz and Dr. Bell told us at the last support group meeting on Nov. 2nd, Tri Care is now being run by Healthnet Inc and they made a decision not to cover the gastric bypass surgery done laproscopically. There was no notice given to the surgeons or patients at al of this decision. In the past Tri Care covered the surgery with very little problem but that is not the case at this point in time. I would suggest getting on the phone and calling your legislators, the insurance commissioner etc. The more people who make waves the better chance at having this decision reversed. You might also want to call your benefits people to have them check it out also. Good Luck. I am sure you are soooo upset right now but the insurance companies are making all kinds of changes everyday and that isn't right. Linda

As a guess as to why they don't want to cover lap vs open.... 1: Lap requires 2 surgeons when open requires one. Cost issue. 2: Open takes less time usually. Cost issue. 3: When open is done, it is easier to check for complications. Cost issue. See any pattern?? Peter

Tara, I am one of Dr Bell's patients. I have gone through all the hurdles, we even had our initial consultation, as well as informed of our surgery date..Jan 24th...5 days later the office called and said we were on hold..due to the tricare prime policy. I usually would have gone after the system viciously but I have been too consumed on another issue..my youngest son is in Fallujah Iraq and I have not been up to the task of taking this on as I had previously fought my way to this point.. On Monday Linda from Dr Bells office called and said the surgery is cancelled..I'm just so depressed on so many fronts.... Paula