Tricare Standard in the MD/VA/PA/DC area

I know there have been a lot of questions regarding Tricare and PS. I'm hoping for some advice from people locally who have already had PS or are in the process. I live in the Frederick/Fort Detrick area. I'm on Tricare Standard until Aug/Sept when I can re-enroll into Prime. My question is, for those who have Standard, how did you start the process? I don't have a PCM to go to. Do I self refer to a surgeon that takes Tricare? I've found some surgeons in and around the Frederick area who take Tricare Standard, and even some that have experience in post WLS PS.

My next question is for those on Prime (who live around the MD, VA, PA, DC area) how did you start? Did you go to your PCM? I've heard that they do PS at Bethesda as practice to prepare for the wounded warriors. Anyone know about this? I'm pretty sure I'd qualify for a TT because of the excess skin, but I'm not sure about a breast lift/ reduction. I know people who have had both procedures paid for in full by Tricare, I just don't know where to start!

Do I wait for Prime? Or start the process with Standard?

Thanks so much, in advance!

I have standard and I just went to a PS who took tricare.  But you are going to need documentation of on going issues the excess skin is causing.  What do you have to do to be seen at Bethesda for other things?  I would just call the PS department and ask them about it.

If I am not mistaken with Prime one has to have a referral from the PCM for all specialty care. 

 If you can get it done on a base that will be the easiest way to go. I tried but was denied. I was able twice to get referrals to PS and tricare paid for the visits. The PS is the one who will send the info in to tricare. I had documented  rashes and treatments that I gave the ps to submit. The rules changed recently and in order to get a tummy tuck you really have to have a large panni that hangs down below your vagina or have other issues and get it done at the same time you are having another abdominal surgery. Just because I had no luck doesn't mean you shouldn't try. Get a referral from your pcm and go from there. I wish you luck, you never know. It may just depend on *****views it at tricare. It works the same no matter what region.