TRICARE INSURANCE

I cant seem to get TRICARE to give me any names of DR.s for bariatrics...basically I was told I had to find them...anyone know of a Dr in South Florida area?  If so please email me at [email protected]  Thank you!

which surgery do you want?  You could do a search at the ASBS website based on your zip code and then start calling.  Unfortunately Tricare is not very helpful when it comes to finding a bariatric surgeon.  Of course that may partly be due to the fact that so few surgeons accept Tricare assignment. Red

the tricare website has a list of all Drs that accept tricare. All you have to do is put in your zip code and it will bring them up.  http://hmd.humana-military.com/South/main.asp   hope this helps and Good Luck to you!!!!

Have you even seen you PCM for a referral? I have Tricare Prime, and had my surgery april6, 2006. There is a whole "process" that you have to go thru for Tricare. You have to been eeing your PCM for 6 motnhs for "diet counseling" and in their notes it has to document that you discussed your weight/weight loss and that you were actually weighed. You have to not miss one month in that time. You need to have a sleep study, see a psychartrist, and a nutritionist.Then after you have all this in place they will put in a referral for a Bariatric dr. When I was done, I just asked for copies of my records for the last 6 months, and took it with me to my bariatric Dr. Then I had to do everything that the surgeon wants done.  This was the process for me and 3 other women here that I am really good friends with. I got lucky, and had a PCM that knew what had to be done and was extremely supportive and helpful. Some don't have that, and then they get the added stress of changing PCM bc theirs doesnt want to help. This is all for people that aren't seen on base, or that bariatric surgery isn't offered on base. Some bases that have an actual hospital, offer gastric bypass. But from what I have heard the wait on base, is over a year in some places.  Overall, from what I experienced, Tricare was really easy to work with. As long as you follow what they want you to do to the letter.  Good luck, and I hope this helped! Take care~ Jen

Hi Jen, Yes I am seeing my PCM and he is supportive...I have documentation of dieting, counsel etc....and having past 10 years of medical history with other Dr.s as well with proof of my fluctuations, medications and attempts...I pray that this will go through quickly...I am ballooning and getting heavier and heavier..I am just starting process...found a bariatric surgeon but seeking info on others as well...supposedly needing a referral to go see him and PCM working on that...I am seeina psychiatrist, psychologist and other medical personnel...now have osteoarthritis and had knee surgery from joints...maybe I could call you and sometime and get to know some other hoops I will have to jump thru! 786 566 9797   cell Hugs! Heidi

I had to research and find a surgeon in my area. I know that if you find a hospital in your area that does the surgery, then you can contact them and they will tell you if their surgeons take tricare. Be aware that some surgeons want to take care of the referral in their office and don't want you to get a referral from your PCM, like the group at Tampa General.  Good luck and be aware that once Tricare gets the info it is a quick approval process.

Thank you Judith, I found a hospital and still researching other surgeons and facilities! Heidi

I'm going through this now. I have tricare prime and had an appt today with my surgeon and his staff to get things rolling.  according to the paper they have from tricare I need: 6 month MEDICALLY SUPERVISED DIET.   sleep study endocrine work up PUD excluded by egd/ugi/h.pylori drug and alcohol screen medical clearance by pcm pulmonary clearance by a pulmonologist cardiac clearance by a cardiologist upper endoscopy phsyc eval and medical records for 2 years. *sigh* I asked if I had been on diets before would that count and she said no.  today had to be day one for tricare. :( good luck.

I went to the group at Tampa general and had the referral from my PCM to go there. Not from the office there. There are support groups offered thru the USF physicians group at Tampa general, alot of us that have had surgery go to the pre-op support group to speak and answer questions of those getting ready to go thru surgery. It is online(dates/times) at usfphysiciansgroup.com go to clinical specialities then weight loss surgery and you will get background info and any other info that you would want on the staff.  They were/are wonderful to deal with before, during and after surgery.  If you need any other info just let me know Take care~ Jen

I met with the insurance lady from the surgeon that is going todo my sugery and she said that "Tricare prime is the best to work with, they even cover tummy tucks. "

This is what they require for approval.
(copied right from the manual)
TRICARE covers gastric bypass, gastric stapling and gastroplasty to include vertical banded gastroplasty and laparoscopic adjustable gastric banding (Lap-Band surgery) is covered only when the beneficiary meets one of the following conditions:
Is 100 pounds over ideal weight for height and bone structure and has one of these associated conditions: diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome, hypothalamic disorders or severe arthritis of the weight-bearing joints
Is 200 percent or more over ideal weight for height and bone structure
Has had intestinal bypass or other surgery for obesity and because of complications, requires another surgery (takedown)


She said once I have my blood work, and gal bladder ultra sound, and pysh Eval, approval takes about 5- 7 days, if I get it all done I could have the sugery first week in March.

Here is the link to the site http://www.tricare.mil/mybenefit/jsp/Medical/IsItCovered.do?kw=Gastric+Bypass&topic=Women