Tricare PRIME and plastics after WLS - HELP!

Hello all :) I saw my plastic surgeon yesterday and she is ready to put in the papers for my transverse pannus removal (all around). We have Tricare PRIME (active duty military) and I was hoping someone else out there has gone through this. Any tips/suggestions for putting in my papers and getting it APPROVED would be VERY appreciated. I do have WELL DOCUMENTED skin issues, but thought I would ask around. Thanks :)

 I wish you luck. I have prime with triwest and thought I had enough documented. They sent me to two different plastic surgeons and paid for the visits but when push came to shove I was denied. They basically told me if I had to have another abdominal surgery I could get the panni done then but not as a stand alone. I went ahead and did it on my own and they removed five pounds of skin. I have heard they will pay in some cases but that person had 22 pounds of skin removed. There is a letter somewhere on her a doctor wrote as a guide for the surgeon to use to call it a medical necessity. Maybe you can find it thru a search. It may be the rules have changed or I wasn't bad enough for them.The problem I saw was most of the doctors do not want to file it. I had one refuse to even try. They did pay him and when I asked for another referral they paid it too.  If there is a chance to get it done on a military base I would try that. I do know you need to get your PCM to write a letter saying its a medical need. I didn't have that. Once again good luck. Maybe someone else will have more info for you.

I helped a friend with an appeal for Tricare.  Tricare wants to know that the extra skin is making you sick.  They are going to want to want extensive documentation of long term skin issues that have not been resolved by medicines.  They are also going to be looking at how far down the panni hangs.  Psychological issues will not be considered by tricare.  If you have not already, you might want to look at the tricare reg on plastics.