I Had My Group Consult at Madigan
I went for my group consult on April 20, at Madigan Army Medical Center. Yeh!!!. This is the first step in my journey towards surgery. The good news it's all free, but is it really when the wait is any where from 6 mos. to 2 years.
Question: Is everything still paid for by Tricare Prime if I see a doctor outside of Madigan?
Hi Gloria,
I was just refered to madigan by my PCP to set up a group consult. I called and they told me to call back in 2 weeks when the May schedule was posted. My doc told me the waiting list is aprox. 1 year. I didn't even know that you could see a different doc outside of Madigan... where did you find this info? I have a hard time waiting, and would love to know about other options.
Thanks so much!!
Jess
Just call up Tricare and tell them that since the wait is 2 years, you would like a referral to a civilian doctor. The only one in the area that takes Tricare is Dr. Weber. If you just want to check him out, his orientation is held once a month and is free. You don't need a consult to see him.
Tricare in our area is making some changes. A new company is taking over Tricare as of June 1. I don't know if it will get harder to get approval for the surgery or not. Since my paperwork won't be submitted until (hopefully) right after June 1, I hope the requirements don't change much. As it is now, these are the requirements.
"Is gastric bypass a TRICARE covered procedure?
Gastric bypass, gastric stapling, or gastroplasty, to include vertical banded gastroplasty is covered by TRICARE when one of the following conditions is met:
A. 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 weight-bearing joints.
B. 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.
C. The patient has had an intestinal bypass or other surgery for obesity and, because of complications, requires a second surgery.
Laparoscopic gastric bypass is NOT covered by TRICARE because safety studies have not been conclusive."
If you want to read someone's story, check out this profile. http://www.obesityhelp.com/morbidobesity/profile.phtml?N=U1040663080
And, mine might have some info on it that might help you. I started my profile hoping to be able to provide answers to other Tricare people that I was looking for when I got started. Now I think it has turned into mindless ramblings.
OK Gloria, which one was you? I was running late and was completely unorganized. My brain was also close to fried with two of these orientations in two days. I was sitting behind the active duty guy. Once during the presentation, I remembered to find you, and then promptly forgot when the break came. When I got home, I had a big hand printed "DUH" on my forehead when I remembered that I forgot.
Re: Your question, it is covered 100% as of now. The only thing I have had to pay for was part of the psych eval. That will be 100 to 200 dollars. Tricare pays for the testing, but won't pay for the report to be typed up. Go figure. The guy I am going to see said that he will do everything he can to get them to pay for it. And, he seemed really nice. I can let you know after I see him. All of the other testing has been done on base or at Madigan. The surgery itself is free.
How informative was the consult?? I have mine 05 May. Nervous? No. Ready to blow Madigan into pieces? Why, YES! Starting with the TRICare office! Come to find out, my referral is expired, it is only good for 90 days. I called my PCP and have to go through all the junk all over again. Good thing she had my file, she went ahead and referred me to Nutrition Care as well as General Surgery, but made me promise to be in her office asap. Mind you, my last PCP said I was an onion and he was going to peel me. Yeah.... so anyways, here we go....... starting tonight, I have to fast for 12 hours and go in for blood work first thing tomarrow, if my hubby wakes me up so I can get the car. If not, he is SO grounded. He's already on my hit list anyways. Which brings me back to the conclusion... I should have been a nun.
I wonder if they will ever come out with No-Stress pills?
Good luck, will write again soon.
Guess what Renee,
They don't give you any information that you can't find out on this web site or the internet.
They gave us a 12 page print out that is on there Madigan web site. I had already printed that out and had it in my folder.
We go to:
--Nutrition Clinic
--Physical Therapy Clinic
We have to call Tricare and make an appointment for the group sessions.
--Occupational Therapy Clinic
--Behavioral Health Clinic
Will contact us.
We are on a waiting list. We will receive a letter indicating our eligibility of the surgery.
We call our PCP in 6 mos to see where we are on the list.
They have a Gastric Bypass Support Group, the next meeting is May 11, 3-4pm at the Nutrition Clinic
They give a list of other support groups.
They have increase surgeries per week. They will give referral to other doctors.
That is all I can think of for now if I think of anything else. I will let you know.