Anyone gottenTriCare Standard to pay for a VSG?

Hi There,

I am going through all the preliminary stuff to get VSG surgery.  In researching my coverage with TriCare Standard, it appears it is not covered...However after viewing some of your messages....is there anyone who has Tri-Care who has been successful in making an appeal and gaining any kind of coverage for VSG surgery?  It wasn't mentioned by my surgeon as a possibility, just self pay....Thanks for your help.  LAC

Hello!

I had Tri Care also and they covered my WHOLE gastric bypass surgery. You have to jump through there hoops to get approved. I had to get a refferal from my PCM which is my family dr. Then I had to wait to get approved to just have a consultation with my surgeon. Next thing I know I was seeing the psychologist and everything got approved. Just do what they want you to do to get it done. DOn't be afraid to call them!


I hope this helps!!!

Many thanks for your response.....Tricare will approve the bipass, but as a former ICU Nurse I saw several horror stories that were the result of bypass surgery gone bad, so decided to go with the vertical sleeve instead which doesn't involve any changes to rerouting the anatomy.  Your right though, tricare would cover either the bypass and the band without much problem if you follow the protocol.  Wish I hadn't seen some of the "boo boos" I saw and I probably would have gone that way.  Hope all is going well for you, and that everything was a success!  LAC