Tricare denied my panni..suggestions?

mommychan
on 1/13/10 10:02 am - North Little Rock, AR
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?!?!
misplaced NY'er
on 1/13/10 12:25 pm
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.
(deactivated member)
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
mommychan
on 1/13/10 11:34 pm - North Little Rock, AR
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!
azreggie
on 1/15/10 5:17 am - Tucson, AZ
I had a TT and Tricare approved the whole thing.  I had started having my rashes documented early on with my primary care and my Dermatologist.  They took pictures at the plastic surgeons and submitted and I was approved right away.

Reggie

Redhaired
on 1/18/10 1:07 pm - Mouseville, FL
Appeal -- appeal -- appeal!!!!!!!!!!  But be careful of your timeline.  You only have a short window of time to get your appeal in.  What was the stated reason for the denial.

  

 

 

hazmat11
on 1/14/10 9:00 pm
 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.
Susie



Leah H.
on 1/15/10 6:22 am - TX
I think Fawn had hers approved through a military MTF. Are you near one?


Extended Tummy Tuck & Breast Lift W/Dr. Sauceda 12/30/2009

Most Active
×