Help with Tricare for a Newbie

A year or so ago I was thinking of WLS, but at the time Tricare only covered GYR and not lapband.  But I qualified under the other requirements.  Now they seem to have added lapband but changed the other requirements.  I thought they went by BMI but now they say 100 lbs. overweight.  Since I am only 5 ft. tall, I don't think I'll be 100 lbs. but I have BMI of 37+ with diabetes, hypertension, & arthritis.  Anybody have experience with new rules? Thanks!

I am dealing with tricare now, I want to have RYN .  I am 5'5' as of yesterday 227 and I have diabetes, and I have been denied twice only to find out that I needed to be 100lbs overweight for my height and bone structure.  Well Tricare uses the metlife scale and they have me as a medium frame so I need to weigh 230lbs to qualify, but my Dr.is writing a letter explaining I am small frame and therefore I qualify and well be sending in a new appeals letter this week .( I was told by Tricare I needed to be 230 to get the surgery and I will be )  Here is the link to the metlife scale so you can see where you stand on their  scale http://www.halls.md/ideal-weight/body.htm.  I hope this helps

Seems like 100 pounds over really isn't the same for us and for someone really tall!  I hate to think of having to gain a few pounds just to fet the RYN!  Let me know what happens with you.  I have decided to get the RYN if possible because I am diabetic, too, and it seems to practically be a cure for diabetes.  If TRICARE pays 80% how much are we left looking at paying ourselves?  Thanks for answering my questions, and let me hear how it goes with you. Diana

Tricare pays 100% my husband had WLS in Feb.  and we didn't pay anything

What are the diet requirements on Tricare?         

What a bummer. I saw my dr. for my initial consult on 18 Apr and I haven't heard anything from Tricare yet. I'm not 100 lbs. overweight either. My BMI is 37 with diabetes, heart attack, high cholesterol, and high triglycerides. I hope to hear something positive soon.

Wow, it seems to me they sure are arbitrary!  I have been wondering if Tricare has a list of docs you have to use (like providers) or do you just need to find one who will accept Tricare?  We don't live near a military area and a lot of docs here won't take Tricare.  I wish I had been brave enough to go to the initial consult already.  I have been dithering around and just about 99% sure now.  Let me know how it goes!

Do you have Tricare Prime or Standard? With Prime, you'll have to use their doctors and stay within region; with Standard, I think it's whatever doctor you find.

I do believe 200% over your ideal body weight (IBW) is on their criteria too, not just the 100 pounds over. SO if the met life chart says you should be 98 pounds, then 196 will make you qualify. You should be able to find it online in your regions handbook policy section. The criterial is only like 3 sentences long. Good luck! Bonnie

TriCare does cover lap band.  I'm going through the process of having it done now.