Tricare Prime Denied me

texgirl66
on 3/1/10 2:59 am
This is my first denial. I'm so pissed. Now I wait on my letter so I can appeal. I am seroisly thinking of going to Darnall here on post and trying to get the surgery. I have read and heard that it is easier when you get it done on post. Any advice???
Thanks,
Sarah448
on 3/1/10 6:52 am - Friendswood, TX
I am sorry you were denied - that really sucks.

I would call and find out why you were denied even though you have to wait for paperwork to appeal.  That way, if it is some additional paperowrk that is missing you can start tracking it down.

Good luck.

texgirl66
on 3/1/10 11:18 pm
My letter was in the mail when I got home. It says I don't meet the requirements. What really blows is that I have put on about 15 lbs to meet the 40 bmi (I am 5' 205 lbs now) only to now be told that tricare does not follow the bmi chart. I really don't want to put on any more weight just to try to appeal. I am barely fitting in the clothes I have now and don't want to spend more money on clothes. I guess I will just do it my self and watch what I eat from now on.
Sarah448
on 3/1/10 11:30 pm - Friendswood, TX
I would still call them to find out exactly what their weight requirements are if they do not use BMI.  My insurance (and many others I know of) required a 5-year weight history to make sure someone wasn't just gaining weight to get approval or stuffed their pockets with rocks on their initial consult.  I had to be careful with my weight history because some of the years when I was faithful to the Weigh****chers program I was under the BMI of 40.  If that is the case with Tricare then at least you will know, but I would still appeal.

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