WHAT TRICARE PRIME TO PAY FOR LAPBAND, ANY SUGGESTIONS?

Hi, I am new to this. I want to have the lap band real bad. I meet all the criteria to having it done. The only problem is paying for it. Like I said I have Tricare Prime. My husband is retired army. My primary care manager is a civilian dr. He has suggested it, since he has been caring for me for the last year, and I went to him originally to get a referrel, but he wouldn't entertain the idea until he saw me try.. Anyway, While looking and calling Tricare to see if covered, they said no for the lap band but gastric bypass is. I asked why, and they said that it was experiamental. Is there anyway to change their minds? The side effects, the surgery itself, recovery time, are so much better than the gastric bypass. Deaths are even much less if none with the LapBand. So how can I get started to get approved? I really want this surgery. In the long run it would be cheaper for them to pay for it, then pay for the price of meds. Maybe all of us military spouses and members, active and retired need to band together and push for this coverage. Thanks horseshowmom

Hey there, I am tricare prime as well and was told 'no' for the lapband.  I am somewhat happy they dont allow it as I truly do not feel I would have been successful with that.  I was told that they do not cover it because it is reversible.  At first i was only interested in lapband because bypass scared the hell out of me.  People like my dad who need this surgery because they cannot have the gastric bypass due to hear conditions and what not, I think for those people they should cover it.  there is no way to change their minds that I know of.  Good luck to you!  I do recommend you do more research, if you do go to them have stated facts and documentation.  I can tell you that there has been studies done that show that in some percentages of pt, the band has "eaten" through the lining of the stomach, other complications include slipping and fillings.  My turning moment was when I learned that anything you can get past the band gets fully absorbed... so if you wanted to sit and eat a hand full of  hershey kisses, you could, andyour body would absorb every calorie... me... i would try it, I am not as disciplined as I thought I was.  I know with the band you can expect to lose lik 60% of your excess body fat over the course of a few years, with the bypass you can expect 75%-80% in one year.  True you have to take vitamins for life, but they are chewable and yummy and 75 pounds liter, i can tell you, I dont mind the vitamins....  I wish you the best of luck in your decision process, I highly recommend coming back to this site, reading the forums for banding and rny and reading peoples stories, (I think I logged like 50 hours of OH time on my computer before I was convinced enough to go through with it!) Good Luck!

I too have Tricare Prime and was interested in the Lap Band originally. They said it hadn't been around long enough and they considered it experimental so I started reading more on the Roux-en-Y bypass. I went to seminars with two different surgeons and the more I heard, the more I was for the bypass instead of the Lap Band.  I really don't know what to tell you on how to go about getting them to change their policy. It's kind of like them deciding what drugs we can get at the on base pharmacy. They don't carry a few of mine because they say they are too expensive. So I go to Walgreens. :) Tricare just approved me this past Thursday and I'll be doing the gastric bypass.

Take care, Cindy

good luck to the both of you on your decision. I am still going to see if maybe i can get some other insurance or just pay out right for the surgery. I am just so frustrated !!!