Recent Posts
Topic: Duodenal Switch and Tricare Prime?
Has anyone gotten approved for DS through Tricare Prime? I'm in Florida.
Topic: RE: Fort Gordon, Eisenhower Army Medical Hospital (Augusta, GA)
We are currently TRIWEST in AZ and I was denide from tricare b/c i don't have one of there 7 co-morbilites even though I have some they aren't the ones tricare uses. We are relocating this summer for my husband to attend grad school and we will end up in Savannah or Boulder. I am looking into military bases that do the surgery so I don't have to go through tricare again. I have been approved twice for this before and both times ended up pregos. Now that, that won't happen again I am ready and tricare tells me, sorry the rules changed, too bad. URGGG!! So like I was saying I am looking into military bases that offer the procedure on post. What was your experience like?
(deactivated member)
on 11/22/09 4:24 pm - MD
on 11/22/09 4:24 pm - MD
Topic: tri-care
Has anyone had to deal with their pcm referring them to a civilian doctor to only get shuffled around till they found a doctor who accepts TriCare?
Did you have to pay anything or did TriCare cover it?
This is what is happening with my surgery request... i live out of range to use Balboa hospital so,
Tri-Care tells me that when I'm referred by a Military Doctor and I'm referred out to a Civilian Doctor be cause I choose to go to a area clinic, that all cost are covered. But when I call the Doctors that are provided by Tri-Care, they try and tell me the there are co-pays and 50% cost! I talked to Tri-Care once again and they said it is un-true.
Did you have to pay anything or did TriCare cover it?
This is what is happening with my surgery request... i live out of range to use Balboa hospital so,
Tri-Care tells me that when I'm referred by a Military Doctor and I'm referred out to a Civilian Doctor be cause I choose to go to a area clinic, that all cost are covered. But when I call the Doctors that are provided by Tri-Care, they try and tell me the there are co-pays and 50% cost! I talked to Tri-Care once again and they said it is un-true.
Topic: RE: Hi new here!
You can get the 200% over for doing this.Google the metlife table,use the lower number for your height with the medium frame,and multiply by 2.So,I am 5'5, so on the metlife table the lower number is 127,when I multiply it by 2 its 254,so I needed to weigh that to qualify with no comorbids,at my first visit with my surgeon I weighed 286 so I was approved by Tricare with no comorbids.For your height you would have to weigh 266 with no comorbids. I too had my gallbladder removed in May of this year and they didn't count it as a comorbid. You could try to submit to Tricare and see what they say,or (as bad as this sounds) gain 13 pounds so you will qualify with no comorbids. My surgery is tomorrow,
Topic: Anyone out there from sheppard AFB?
May need some help trying to get things going here on base for Post Op Bariatric patients. Would like to know if there are may out there and who may be willing to help. thanks
Topic: RE: Hi new here!
You're not being nosey, it's fine to ask.
The DS is Duodenal Switch - you can look it up under forums/surgical forums; on here to read about it & it just seems the long term lifestyle is much more of one I would enjoy long term. The DS people tend to loose more weight in the first year, and over 5 years a higher percent of DSers keep most of the weight off & continue to loose. They also can eat more ranges & types of food without as many side effects.
Everyoneis going to react a little different from the surgery they have, so you just haveo research what looks best for you.
I'm still learning too & have just gotten a RNY surgery date of Dec 8th, though I am researching the possibilitys (not any i know of) fmy insurance to take me as an exceptin to policy for the DS.
The DS is Duodenal Switch - you can look it up under forums/surgical forums; on here to read about it & it just seems the long term lifestyle is much more of one I would enjoy long term. The DS people tend to loose more weight in the first year, and over 5 years a higher percent of DSers keep most of the weight off & continue to loose. They also can eat more ranges & types of food without as many side effects.
Everyoneis going to react a little different from the surgery they have, so you just haveo research what looks best for you.
I'm still learning too & have just gotten a RNY surgery date of Dec 8th, though I am researching the possibilitys (not any i know of) fmy insurance to take me as an exceptin to policy for the DS.
Topic: RE: Hi new here!
If you dont mind me asking, what is the DS? Ive heard of the gastric bypass and the lapband..but not the ds. Why would you rather have the DS? Im just trying to learn, not be nosey :)
Topic: RE: Hi new here!
your welcome. okay that's good that you'll hae full time coverage. I know I was sure hoping for the DS instead of the RNY, so I may try to fight the insurance, or see if tricare will do an exception to policy. praying things work out for us both :)
Topic: RE: Hi new here!
thanks so much! My husband got out of the guard in april (after 6 years) and just enlisted in the active duty army. so we will still have tricare when he gets home. Thanks so much for your answers. I cant wait to get all of this over with and start losing weight. My doc here in town accepts tricare, Im just not sure if he will give me a referral to a surgeon cause hes really picky about the procedures he recommends.
Topic: RE: Hi new here!
oh ps.. on the main page you can enter your hight and weight and get your BMI - that is what they used for my determination along with sleep apnea.