tricare

lizziedarlin
on 10/5/07 1:32 pm

Ive had all my testing during the process found out my husbands employer had an exclusion. Well we now have tricare which requires a pulmonary and cardiac clerance. Well my cardiac clerance is 1 yr old and pulmonary 7mths old. Do i have to do it all over again? The surgeons office said not over 6mths old. Do i just go back to the drs or do they do the stress test and etc over too? i know i have to have an upper gi and blood work also... does anyone know how long a  approval from tricare takes?                                 thank you.

Wendi W.
on 10/5/07 2:35 pm - Waukegan, IL
Hi, I am on Tricare Prime, and this is what I have found.  For referrals, it takes 7-10 days and I was told 24-48 hours for approval.  Now, this is the military and you have to remember the rule they follow is "Hurry up and wait"   If your doctor asks for you to do another test, he is doing this for your safety and to make sure that there are no hidden problems that have creeped up in the 6-12 months. 
Wendi

   
       
 
lizziedarlin
on 10/7/07 1:37 pm
Hello and yes the military does things there way. My doc says this is what tricare ask for. Is this what you needed for tricare?
deniseg
on 10/10/07 1:21 pm - Monticello, AR
The only thing TriCare requires for WLS  is this: 1.  You must be 100lbs. over ideal body weight with a co-morbidity OR 2. 200% over ideal body weight with no co-morbidity They do not require any additional testing of any kind, at least to my knowledge they don't.  If you have cardiac or pulmonary issues then they may require those tests, I don't know.  If you don't have those issues then they won't require the testing.  Any testing is done per your surgeon's request. You said you know you have to have an upper GI...is that your surgeon's test or is that what he says TriCare requires? I was approved in less than 24hrs.  I had no co-morbs but was approved because of chronic pain in my weight bearing joints.  Good luck to ya!

    DENISE          
Day of surgery weight/BMI:  246/44.9
Goal weight:  135
Current weight/BMI135/24.6---GOAL!!!!!!!!!
Total pounds lost:  111
    
      

                                                            

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