letter to insurance company

Did anyone here with Tricare Prime have to write a letter to Tricare telling them why you need WLS? When I first started out with this journey the first thing I did was call Tricare and find out exactly what they covered and what I had to do as far as authorizations and such. They did not mention a letter but my Doctors office gave me a book on my first visit there Monday and it gave a list of things to do for when I come back in to meet with the surgeon. One of things on the list was a letter to your insurance company with why you need WLS. Just curious if anyone knows if Tricare required that. Thanks for any info on this.

I did not have to write a letter. I never heard of it. But Tricare qualifications are always changing. I would call Tricare and find out.

I didn't have to write a letter either. It is more than likely just a surgeon's requirement. S/he probably deals with a lot of insurance companies that require it, so they just make it an automatic requirement for all patients in their program. My surgeon's program had non-Tricare requirements too; a 5% weigh loss, letter from PCP supporting WLS, 5 year weight history, etc. HTH and Good luck! Andi

yes i did, but my pcm had me do this, and she told me that it wasnt always necessary however when doing this they approve you easier, verces having to go through an appeal process. i didnt do it in a letter format more like a list, i included all the medications i was on, then went on to my issues such as asthma, diabities then listed which medication i use for that problem, how often it is perscribed for and how this problem actually effects me then in a different paragraph i wrote down my diet history best to my ability i also included what weight loss and weight gain i had while on these "diets", and then any training about right food choices, so i included anything i could think of, such as WIC, diabities dietician. i also put down all my blood sugars for the month, then averaged it all out for them. i dunno hopes that helps feel free to ask me any other questions about this -jennifer