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Topic: RE: Tricare help!
I have knee problems. I actually just had knee surgery the end of Mar. The doc that performed the surgery, told me that my cartilige(sp) is sherdding away. So I will have even more problems with my knee in the near future. Also, when I was pregnent with my daughter. I developed gestational diabetes. So that right there puts me at a higher risk of getting it later in life. Theres also a family history of being over weight. Im hoping that these risks right there qualify me for the WLS. According to tricare and the doc I saw about the surgery. My BMI is 37 and I am not 100 lbs over weight. From what they told me. With my height, my ideal weight is 152 to 179 
I did call the tricare office up today. I was told that they(tricare) still needs to translate what the doctor sent them. I was told that I should hear from them no later then next week. I am so keeping my fingers crossed that I get that call saying I got the approval..
-Mary
I did call the tricare office up today. I was told that they(tricare) still needs to translate what the doctor sent them. I was told that I should hear from them no later then next week. I am so keeping my fingers crossed that I get that call saying I got the approval..
-Mary 
Topic: RE: Newbie with LOTS of questions
Yes, like the others have said, the first step it to get a referal to an in-network surgeon. But I'd make sure you know the surgeon you'd like to go to before you see your PCM. My PCM (civilian) did the referal, but didn't specify my surgeon (Dr. Read), so Tricare just assigned me a general surgeon, who didn't even do WLS. (Weird Tricare). It wasn't that big of a deal though, I just called up Tricare and they changed the referal to my surgeon.
Oh, and on what another poster said, Tricare does cover the Psych eval. They covered mine. I just made sure I picked an in-network psych doc (my surgeon's office gave me a list of 5 psych docs they use). Also, you don't need a referal for your first appointment with the Psych doc, but if you see them more then once (my Psych doc did the eval in two visits), the Psych doc will need to do a referal for the extra visits (you don't have to go through your PCM for that).
HTH and Good luck!!
Andi
Topic: RE: Newbie with LOTS of questions
My DH is retired Army. We have a civilian PCM with Tricare Prime. With Prime everthing has to go through your PCM. You have to have a network provider. We have had no problems with the system. My consultaion was approved overnight.
I now have a Tricare nurse for my asthma. She calls me monthly. She is really excited for me to have surgery. She said that Tricare will no longer pay for Lapband. They prefer the gastric bypass and that's what they cover.
Wecome to the board, lots of good support here. Diana
Topic: RE: Newbie with LOTS of questions
My husband is also retired Air Force. That is how I got started I went to my PCM and asked for a referral to see a WLS Surgeon. It was approved right away. I then had my Psych eval which Tri-Care does not cover. Ihad to attend a seminar before I could see the surgeon. I went to the surgeon on the 20th of this month and they submitted my paperwork Tuesday morning and I had approval by last night.
I want to wish you luck on your journey.
Leann
Topic: RE: Got My Date!!
Hurray!!!! I think I understand your feelings. I see my Dr. Monday. I hope the process goes fast. I'm really happy for you and hope to join you soon. Diana 
Topic: Newbie with LOTS of questions
Hi Everyone,
I have been thinking about WLS for over 2 years now. I guess fear has been holding me back but no longer will I allow it. My dh is retired AF and we are moving to ND next month. I am wantong to get the ball rolling. Can I go to my PCM and ask for the referral or do I have to go to a base doc? We have Tricare Prime.
Also, Tricare doesn't pay for Lap Band..... Right?
Thanks for any and all help!
Bobby
Topic: Got My Date!!
Hey all... got it yesterday.. how about that! Is it time to Freak yet?? I'm excited and scared all wrapped up into one. Just want to thank everyone for being on here. I think there's just something special about our military community. Thanks for being here.
Topic: RE: Tricare help!
It only took a little over 24 hours for approval. You need to contact tricare to be sure that your doctor has submitted your paperwork. I didn't think it was going to be easy either I had to jump through a lot of hoops before I could even see the Surgeon. Let me know if there is anything else I can help you with.
Leann
Topic: RE: how long for approval
Here is the website
http://www.humana-military.com/
Good Luck
Leann
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