Tricare won't pay for lap?

I scheduled my consultation with Dr. Rothwell, and Holly told me that they have been having problems with Tricare. Apparently Tricare will pay for the open procedure but not the laproscopic. Has anyone else had any experience with this?

My BCBS wouldn't cover lap either. I had open and my incision is only about 3 1/2". If I'd had lap I would have had 5 or 6 small incisions. I don't see how the open could be that much worse than the lap? They say the open is a faster procedure too, less time under anesthesia??

I am on Eglin AFB, in Florida. We too, have Tricare Prime. I spoke to a girl who did have the Lap RNY, done ON base at this hospital. But...if you go to a surgeon off base with a referral they will only approve Open. SOOOO stupid, I don't understand it!! really!

Tricare Prime paid for my Lap RNY last May, while my husband & I were stationed at Fort Leonard Wood, Missouri. They do not do the surgery on post, and I was referred to a civilian surgeon in Sedalia, Missouri, 3 hours away. Every single aspect of the prep & surgery was covered, except for the nutritional consult required by the hospital. The bill for that came to $40. Many people in my support group at the time (we are now at Ft. Stewart, GA) said that previously, Tricare was not referring patients to any surgeons in our service area that performed lap. They had expanded to include two more surgeons by the time I applied, and both of them performed the lap. So, the scoop may be that the la***** lap decisions are being made by the specific Tricare service area. Each regional area is independent, for better or for worse, so what Tricare covers in one area may not be covered in another. You are more than welcome to email me with any questions. I am pleased beyond measure with the surgery and its results.