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For TFL, Medicare will be your primary insurance. If it is not a covered benefit through medicare, you still need to submit for prior authorization through medicare and get the rejection to send to the contractor for TRICARE for Life when the doctor requests the prior authorization on your procedure. Whether or not TRICARE covers a revision, check tricare.mil and look under "see what's covered" it doesn't list all the exclusions but it is a starting point for you.
Good luck on your surgery! Congratulations! I can tell you my surgery went well.
I got approved so fast I didn't have time to worry about it. I feel a bit weak and tired is the only thing. I am not taking my pain medication other than Tylenol and that is only if I need it-which has been one time.
Pain wasn't a problem for me, I know everyone is different. Everything will go great for you!
We can look forward to an AWESOME 2015!!!
I have a similar policy with Cigna, and was told it does not cover bariatric surgery, even under treatment for MO. I was aware of a surgeon *****paired hiatal hernias, and billed this to the insurance, while he did the VSG and billed for that separately. Those insurance experts looked into my self-funded policy with Cigna (through my employer) and was also told absolutely no coverage for bariatric, regardless of co-morbidity or BMI.
I know it sucks right I have to pay 1,500 to have the surgery. I have Aetna by the way also.
Congrats and goodluck today 😊 My surgery is January 20th.
Thank you. I was worried. I did my pre-op testing today and that is what my surgeon's office told me. Whew. Surgery is tomorrow. Nervous as ever and can't sleep. I have waited years and years for this. I can't believe it is finally here.
My insurance company told me I was approved. As long as your doctor has the approval then you are good.
I am curious, I have read a lot on here to always get an Approval or Authorization Letter from your insurance company prior to having surgery.
I called my insurance company and they said that I have been approved, but I haven't received my authorization letter in the mail. They said they sent it last week when I was approved on a Wednesday, well today is one week and I still haven't gotten it.
Do you think I should still have the surgery? It is scheduled for Friday this week.
does your policy say that bariatric surgery is "an exclusion"? Do you have comorbidities that make it. Medically necessary? What is your BMI?