Tricare Prime letter of necessity

Jillian O.
on 9/15/09 10:49 am - Fort Riley, KS
Does Tricare Prime need a letter of necessity? I got my referral from PCM last month to see the bariatric surgeon and I'm now halfway into the bariatric program,only have a few more things to do until insurance submission. I got all my test done at primary care last week and I have an appointment with primary care this Monday to get the clearance for surgery.I asked the secretary at the bariatrics center about it and she wasn't sure if tricare requires one. I can call tricare tomorrow and ask but I was wondering if anyone here knew.
Wendi W.
on 9/15/09 4:41 pm - Waukegan, IL
From when I was going through the process, they did not but things could have changed.  Because it is my belief that with Tricare, if you did not meet the qualifications for surgery they would not approve the referral. 

Please call them, it won't hurt.

FYI just make sure you meet their requirements as outlined in the benefits book.

Good luck
Wendi

   
       
 
Jillian O.
on 9/15/09 9:59 pm - Fort Riley, KS
Thanks Wendi,
The secretary told me yesterday there are 2 insurance companies who do not require it but she was not sure which ones since she's not the insurance person in the office and after doing a bit more research I am thinking Tricare it one of them,but I will still call. I do meet their requirements as outlined in the benefits book. I am 200% over the ideal weight for my height,I used to metlife table. I am 5'5 and 286.
Jillian O.
on 9/15/09 10:26 pm - Fort Riley, KS
Wendi,
Do I need to call Humana-Military (we are in the south region) or is there a main Tricare number I call?
Jillian O.
on 9/16/09 3:28 am - Fort Riley, KS
Just giving an upate for anyone who is following. I called Tricare(Humana-Military) and a very nice representative told me the letter of necessity is not needed because when my PCM sent the request for a referral to tricare with my height and weight along with diets I have tried that was the same thing as giving tricare a medical letter of necessity. I'm glad,one less thing to stress about.
akindofmagick
on 9/16/09 2:41 pm - MD
Excellent news - good luck!!

Sheri (Tricare Standard)

I've been fat, and I've been thin - and thin is better.  

There is a better way. --Alaine of Lyndar 
--------------------------
HW: 234. SW: 228 (18 June 2015). GW: 137. Specs: 50ish, 5'4"

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