Navy Insurance

I am a new Navy Wife (2 weeks) and am being put on my husbands insurance (not sure but i believe it is tricare) and I was wondering if any of you knew if Navy Insurance will approve the surgery (I would def have a dr's reccommendation, easily)  and If they do... what are their requirements and what percentage do they pay?   I dont have any info on the Navy insurance yet as my husband just went to his first command and I'm in CO and he is in VA so i'm just wondering... if any of you know please Respond here or Feel free to e-mail me at [email protected]. I greatly appreciate it Krissy

Krissy,  If you have a military ID card you have already been enrolled in DEERS, if not, then you husband needs to add you as soon as possible.  Once enrolled in DEERS you can and will be enrolled in the Tricare (military medical insurance) system, you (or your husband) must choose which type of coverage you want - Prime or Standard.  With Prime there are no co-pays, etc (all free), but you usually have to be seen at a military facility.  With Standard there are co-pays but you choose your own doctors. Will you be moving to VA?  Where you live will determine which Tricare region you will be "served" by (seved being a relative term...).  Tricare is pretty easy to get approval from if you meet their crieteria, 100 lbs overweight with a co-morbidity, or 200% over ideal weight.  At present they don't routinely approve the lap band surgery, though I have heard that it's being done at Walter Reed Army Med. Center.   I recently chose to switch from Tricare Prime to Tricare Standard because the waiting list for surgery at the Navy Hospital here was nearly two years.  Tricare Prime wouldn't allow me to be seen elsewhere, so I switched to Standard.  I hope that helps!  Welcome to the adventure of being a Navy wife.

Thats the problem... I was hoping to have Lap Band and thats Primarily because Number one the risks are lower, and number 2, I'm only 24 and plan on having kids still and the lap band would be most conducive to me having children and still losing weight.      I would definitely meet their criteria for WLS but I just have to wonder if my argument would be compelling to the company or not... probably not... which means I wont have weight loss surgery, because right now, i'm just not sure about RNY with still wanting to have kids...  *sigh*   Not happy Krissy

From what I understand (so far) Tricare Prime does cover bypass and some banding procedures.  I should have a better idea soon as my PCM is refering me for the procedure.  Hopefully this is correct (I'm assigned to a civilian Dr. in my area).  Check out their website.

Krissy,  Sorry so long in responding, I didn't see this until just now.  I think I would definitely pursue having Tricare cover the lap band.  I know they are doing the lap band surgery at Walter Reed Army Medical.  I would think if they are doing it there, there must be other bases in the country where it is being done.  Pursue it!  You have nothing to lose other than a little time hassling with Tricare....well, and that tends to make the blood pressure rise, but it's worth a try!  Go for it!  See your PCM, get a referral to a surgeon who does lap band, research whether or not any military medical facilities in your area are doing lap band (don't trust Tricare for this info - call the hospitals themselves).  A little bit of legwork on your part could go a long way towards full coverage for the procedure.   My oldest daughter (29) had lap band surgery a few months ago.  She chose that over RNY for the same reasons you are, and I think it was the best choice for her.

Okay, I think I will see what I can do about getting them to cover it... I'll prob have to jump through a bunch of hoops but since my husband is out to sea right now, I'm not enrolled in DEERS right now... Do I need him to do it (he procrastinates) or can I do it myself?   If so... How?  LOL   Thank you for your help so far.   I greatly appreciate it. Krissy

Hey- I'm now hearing that TriCare is adding LapBand to their list of approved surgeries as of 2007!