BMI of 35
ronimac
on 2/23/08 11:10 am - Raleigh, NC
on 2/23/08 11:10 am - Raleigh, NC
I have a BMI of 35 plus 2 comorbilities and am interested in the Lap Band procedure. Any suggestions? I have Tricare insurance.
Have you checked online at Tricare's website?
Tricare doesn't go by BMI for approval. They use the Metropolitian Life weight chart (a copy found here http://www.halls.md/ideal-weight/met.htm ) with the following guidelines.
"Gastric bypass, gastric stapling, or gastroplasty—to include vertical banded gastroplasty—is covered when one of the following conditions is met:
1. The patient is 100 pounds over the ideal weight for height and bone structure and has one of these associated medical conditions: diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome (and other severe respiratory diseases), hypothalamic disorders, and severe arthritis of the weightbearing joints.
2. The patient is 200 percent or more of the ideal weight for height and bone structure. An associated medical condition is not required for this category.
3. The patient has had an intestinal bypass or other surgery for obesity and, because of complications, requires a second surgery (a takedown)."
Here is the link to the Tricare Prime Handbook, look on page 23. https://www.hnfs.net/res/tricare/beneficiary/common/pdf/5436 00236/Prime_Handbook_final_11_06_06.pdf
or if you have Tricare Standard, that handbook, look on page 19. https://www.hnfs.net/res/tricare/beneficiary/common/pdf/-123 6223428/Standard_Handbook_09_06_final.pdf
Hope this helps you some,
Andi
Editted to add: I couldn't find an updated handbook with the LapBand listed as an approved surgery, but I know it is (just approved in the last month or two I believe). I'd assume the weight requirements would be the same, but you could call up Tricare and find out for sure.
Andi Highest 278 lbs, Pre-op 269 lbs, Goal/Current 150/160 lbs
Currently looking into plastics...
Change the voices in your head... Make them like you instead.
Currently looking into plastics...
Change the voices in your head... Make them like you instead.
ronimac
on 2/24/08 4:40 am - Raleigh, NC
on 2/24/08 4:40 am - Raleigh, NC
Thanks for the info. The Met Life Wt table is kinder and gentler than the stated require "100" lbs over. Did you have the Lap Band?
As far as you wt loss, "You Go Girl!!!"
thanks
No, I didn't have the LapBand. I had the RNY back in July. I know there were a couple of people on the military board (when the military board was alive) waiting for Tricare to include the Lap Band as a WLS choice in the policy. But after I had done my research on all the different WLS choices, RNY turned out to be the perfect fit for me. And so far so good. And a big THANK YOU for your compliment and encouragement! It is always nice to hear! Andi
Andi Highest 278 lbs, Pre-op 269 lbs, Goal/Current 150/160 lbs
Currently looking into plastics...
Change the voices in your head... Make them like you instead.
Currently looking into plastics...
Change the voices in your head... Make them like you instead.