Tricare denied my panni..suggestions?
I am SO BUMMED!!! Seems like just a year ago Tricare Prime was on board with getting rid of excess skin, lifting breasts, etc., but now the word is that they're denying people left and rigt...including me! I don't have to tell any of you how bothersome the saggy skin is...rashes, dry itchy patches, etc., but how does one go about convincing Tricare Prime that I do indeed need this surgery for health reasons?!?!
That is very disappointing to hear. I have Tricare Prime too. I am going to talk with my PCM about this on Friday. I have done so much research on this subject. What I got from all of it was it really depends on if your PCM is supportive of you having this surgery. Though I could be completely wrong.
What kind of documentation do you have? Is your PCM supportive of you having this surgery?
I will definitely be watching this for replies.
What kind of documentation do you have? Is your PCM supportive of you having this surgery?
I will definitely be watching this for replies.
(deactivated member)
on 1/13/10 12:53 pm - Haleiwa, HI
on 1/13/10 12:53 pm - Haleiwa, HI
I am Tricare Prime, and you have to have tons of documentaton to show you have been having rashes treated and medication is not working. I was told by Tricare that it had to be a life threatening condition before they would approve it. I had rashes documented, but it was treated with the creams and worked. I had to self pay for all of my plastics.
Good luck!
Jessica
www.livingtheskinnylife.blogspot.com
Good luck!
Jessica
www.livingtheskinnylife.blogspot.com
Thanks for your replies! My PCM is supportive of the proceedure, so I guess we'll just continue to take pictures of the rashes and document the trial & error of the medications I try. I figure I'll wind up having to pay for everything myself, but I wanted feedback about whether pursing it through Tricare was even worth my time. I just don't understand them anymore...3 years ago they were so good about everything, but lately you have to be at death's door to have them take care of you! BOO!
I am trying next week for approval. I have had two referrals to PS's. I read the coverage and I am concerned I won't get approved. It is not clear if you need all of the qualifications or just one (in the handbook) I do not have any PS's at my local base so I will be stuck if I do not get approved. If anyone has suggestions please post them.