DS approved by Tricare? Anyone?!

I am looking to hear from anyone who has gotten a DS approved by Tricare.  I am simply looking for someone who has ALREADY been approved. Just want to see if I have any chance with actually trying to go through with getting a PCM referal to a surgeon only to be denied when I will only entertain the revision to DS. I will go through the long agonizing process of appeal (if need be).
I have done my homework, and the only and best choice for my revision is the DS. Hands Down!

I know Tricare covers RNY and Band so please don't send me the handbook or lecture me on what they do not cover. I just want to know if anyone actually pushed hard enough to get it done.

Thanks!!! :)

Once  upon a time there was a loophole where some people got it done through funky coding. That loophole has since been closed. There has been no shortage of people appealing and pushing and even taking it to their Congresscritters. It will not happen.

Unfortunately, because you are a revision, you don't meet the criteria for a particular self pay option that's currently available. I was just all set to tell you contact info and then saw that word. Drat :-(. I'm sorry.

For what it's worth, I think there's only one surgeon that does DS that Tricare will approve, and that's Dr. Matthew Martin at Madigan Army Hospital in Washington.

One of the vets can chime in here like they did for me, or maybe you can find where I asked this same question about 3 months ago!   But the quick answer is NO!   There is a vetted DS surgeon 3 hours from me and TRICARE WILL NOT COVER THE DS AND YOU CAN NOT APPEAL.....Tricare is a different animal than say BXBS.

Your only hope is Dr. Martin at Madigan.....which is why am I leaving my 4 kids with my X (shutter at that thought) and flying to WA and staying 3+weeks to get the DS!!

Unfortunately, I had to delete this post due to privacy concerns.

 I had a DS, used Tricare, and did not use the Dr. a few of the people responded stated.  I was not 50%+ BMI but I was close, and I think honestly it's kind of on a case by case basis. I didn't even have to push that hard.  I made the decision it was the best option for me, my doctor agreed, I went through the bariatric pathway, and then spoke to my surgeon regarding my actual WLS options.  I don't know why it would be such an issue, perhaps because it's a revision?  Good luck!!!

Did you have your DS in a MTF?

I'm fairly sure Dr. Carter is at Madigan which is the same MTF that Dr. Martin is at.....so in a sense Tricare didn't actually cover it per se.

Okay yes a MTF and yes at Madigan, however it still is something that is processed through Tricare.  Maybe I'm not fully understanding the disconnect.  Either way I wish the original poster the best of luck! :)  Sorry that apparently my information was of no help!

~Sandra

Procedures done at a MTF (or in some cases in VA hospitals) are a different animal altogether. There is no way to get a DS, virgin or revision, paid for by Tricare EXCEPT at a MTF done by a surgeon employed by that MTF. (In other words, there's no such thing as bringing in a guest surgeon to the MTF in order to get your DS.)