Tricare Policy Changes!

I had the question below about Tricare and the letter that I received this weekend stating that the lap gastric bypass was considered unsafe to them. I have since been in contact with Tricare and as of last week they changed their policy in regards to gastric bypass. They will continue to cover the open procedure of gastric bypass but they will not approve the lap procedure anymore--they said that the lap procedure is now considered an experimental surgery. There was not explaination of why the change in policy given either to me or anyone that I have been in contact with within Tricare including the appeals department. The decision came from high up the Tricare chain I was told. I am, of course, filing my first appeal and I was told that if denied again to appeal again but this time to the upper appeals department. The agent said if enough people do this upper appeals process that they will have to rethink their policy change. I just wanted to let you guys know in case anyone out there has Tricare and is awaiting to have the lap procedure done, either approved or not approved yet. Wish me luck in my first appeals process something which I have never done in my life! Patricia

Hi Patricia, Me again, Carol, When you do your appeal letter, check to see if Portsmouth Naval Hospital is still doing the surgery lap. They have a surgeon there who performs this surgery. If they do ask how it is fair for those dependents to have access to this procedure but not you. Hope this tidbit of information helps. I think that they may have changed the policy after the NJ and Boston deaths that occurred when the stapler misfired. Not sure though. I'll keep you in my prayers. Good Luck!!! Carol