Who has Tricare Prime and advice?!
Hi! I'm in Charleston, SC and I have Tricare Prime. You should get approved quickly w/ Tricare because of your weight, & PCOS. I have PCOS and I'm a bit over 120lbs overweight. I am waiting for approval (which I should hear something tomorrow)- May I ask why Palmetto Health Center? I faught Tricare to change my referral to MUSC and they approved it.
I do not have Tricare, however, I started off like you with no comorbidities, however, was diagnosed with sleep apnea while going through the program. Will you have a sleep study done? You may have apnea and not know it.
~Jen
RNY, 8/1/2011
HW: 348 SW: 306 CW:-fighting regain GW: 140
He who endures, conquers. ~Persius
I have Tricare Prime/.North and the process was easy I think. I do have co-morbs of High Blood pressure, huh it all just started since May, and that's when I saw the surgeon the first time..lol Anyways, there are hoops and all kinds of stuff my drs office had me do before they submitted to Tricare, cardio, had an ekg, echo and stress test, pulmonary, chest xray, abgs, sleep study and then ended up with a ct scan of chest, that was not normal for a ct scan, odd results for chest xray, but nothing wrong with me, it was just a bad xray and should have been redone before I ever left..I had to see a hematologist for a consult and then the psych/nut appointment. AH! After all that, got all the results to the surgeons office, they submitted to Tricare on a Tuesday afternoon, around 2pm and I got approved and surgery date the very same week on Friday! Aug 26th is the big day!! Just go through the motions, keep copies of everything, in case something is lost or misplaced, it happens sometimes and you'll do great!! My first meeting with the surgeon was May 10th and I was approved July 22nd!! Keep us updated!!
Congratulations! Your on the way to a much healthier, happier you!
I am in TriCare West here in Alaska. When I started my journey I weighed 247 pounds and am 5'2" with no co-morbidities. I saw my surgeon for the first time in Oct 2010 and started all of the requirements (nutritionist, upper GI, chest x-ray, EKG, psychological and abdominal ultrasound). Keep copies of all of your results and follow up to make sure your military hospital sends the results over. They didn't send everything which delayed my process a little. Once my surgeon's office got everything,they sent the request to TriCare. About a week later, I was told TriCare denied my request because I had no co-morbidities. My surgeon's office sent in an appeal letter (NOTE: BEFORE your surgeon does an appeal on your behalf, you have to sign a paper found on TriCare's website authorizing them to appeal on your behalf). Because I didn't have the appeal authorization with the appeal, we had to resend it. Then TriCare took 28 days to decide that I met the stipulation of being 200% over ideal body weight. Once I had that approval in March, I saw my surgeon again and we scheduled my surgery for May 12, 2011. My process took longer because I had to chase down test results, deal with holidays, my surgeon took time off and I wanted to wait until I came back from Hawaii to do it. Anyway, I think most people get the process done quickly so don't get frustrated. Also, don't give up if you get denied - just appeal the decision.
For the most part I don't regret doing the surgery. The only time I ever regret it is when I want to eat something that I used to eat and then I just remind myself that eating that food is what got me fat to start with and I'm changing my habits in order to be a healthier, happier me.
Good luck!
Lillian
I am in TriCare West here in Alaska. When I started my journey I weighed 247 pounds and am 5'2" with no co-morbidities. I saw my surgeon for the first time in Oct 2010 and started all of the requirements (nutritionist, upper GI, chest x-ray, EKG, psychological and abdominal ultrasound). Keep copies of all of your results and follow up to make sure your military hospital sends the results over. They didn't send everything which delayed my process a little. Once my surgeon's office got everything,they sent the request to TriCare. About a week later, I was told TriCare denied my request because I had no co-morbidities. My surgeon's office sent in an appeal letter (NOTE: BEFORE your surgeon does an appeal on your behalf, you have to sign a paper found on TriCare's website authorizing them to appeal on your behalf). Because I didn't have the appeal authorization with the appeal, we had to resend it. Then TriCare took 28 days to decide that I met the stipulation of being 200% over ideal body weight. Once I had that approval in March, I saw my surgeon again and we scheduled my surgery for May 12, 2011. My process took longer because I had to chase down test results, deal with holidays, my surgeon took time off and I wanted to wait until I came back from Hawaii to do it. Anyway, I think most people get the process done quickly so don't get frustrated. Also, don't give up if you get denied - just appeal the decision.
For the most part I don't regret doing the surgery. The only time I ever regret it is when I want to eat something that I used to eat and then I just remind myself that eating that food is what got me fat to start with and I'm changing my habits in order to be a healthier, happier me.
Good luck!
Lillian