I Hate Tricare

So it appears I was denied again.  Now the Dr is draging his feet on writing another appeal letter. I called again today and my file is still sitting on his desk.  So as it stands i would have to pay for the gasrectomy as they will never cover that portion. When i asked what that fee would be, they said they had no idea.  I would be billed for the portion of the operating room, dr, and all the other ddr and fees.   i also asked if my band could just be removed and he said no as i have scar tissue from all the years i have had it.  So I am screwed and depressed. Dont know what else to do at this point

He doesn't sound like he does many revisions if he says he can't just remove the band.There are many people that just have the band removed and the scar tissue removed and then get a different procedure later on. If I were you I'd find a new and better doc that know how to deal with this. He also "should" know how much the seperate procedures cost that he does. It all sounds a bit fishy to me.

I was denied twice. My appeal worked.  Tricare is probably different.

If I had been denied again I was going to Mexico.  Ready4aChange - revision from band to sleeve was less than $6000.

 

Yeah if you can not get costs look into Self pay Stewart in Texas or Keshishian in Ca both will quote a cost and bill that cost. There are also Dr's Out of the country. Dr Ungston and one in Brazil I can not remember. 

good luck and keep trying

Whitney

YES Tricare does suck! They denied me because of the one bariatric surgery per lifetime and because I lost enough weight with the band. Well I did lose weight and was fairly successful. now after many years of complications the band is not working so I've gained weight back.

I have TriCare and had a revision from band to RNY.  The band had slipped and was causing a lot of issues.  I know the Dr kept having to submit things but it was finally approved and everything covered.  You may want to go to a different WLS.   My WLS works with TriCare all the time.  Would you consider going as far as Wichita Falls Texas?