Tricare Prime Coverage

msmilene
on 12/4/13 4:21 am

How strict is tricare on their requirement for failed weight loss attempts documentation. I am currently midway through my first month of a medically supervised diet with the bariatric surgeon (civilian). I was told by my PCM (who gave me the referral) and the surgeons office that Tricare requires a 3 month medically supervised diet. Will these three months suffice as the documentation for the failed weight loss attempts, or will I need to provide further evidence?

My surgeon seems pretty confident that my surgery will be approved, but as I am getting some serious anxiety over the possibility of being denied.

Any advice would be greatly appreciated.

Ndalyrn13
on 1/16/14 12:12 pm

Hello! I contacted Tricare and was told there wasn't any specific time period for failed weight loss months just "monthly" documented weights and failed weight loss. I am waiting for my surgeon consult appointment referral to get approved. It's been 2 weeks and everytime I call then they say the referral is still pending! How frustrating! I won't give up yet. I think that's what they want you to do!

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