Experiences with Dr. McMahon &/or TriCare

Hi!  I'm new to this journey and have decided to have a LapRNY.  I'm near Everett.

I'm wondering if anyone has experience with Dr. Ross McMahon they would like to share.

Also, I'm TriCare/TriWest and was hoping to hear from others on their experiences with the approval process, etc.  My husband is retired Coast Guard so we are civilians and use civilian doctors.  :)

Thanks!

 The best thing to do is go to the Tricare office and get a copy of the criteria you need to meet to be eligible for the surgery. It used to be 100% over with co-morbidities, and 200 % if no co-morbidities, but may have changed. The approval process will be the same as with any Tricare. If you are prime, they will first try to send you to military hosp., if not, you probably have to follow the Medicare regs. of using only a facility that is listed as a Bariatric Center of Excellence.
 
  These are assumptions based on my former job as a Tricare benefits rep, however many things have changed in the past few years, so I recommend a visit to a Tricare rep.  If you don't get the answers you need, call another base, because, as with anything, there are different levels of knowledge depending on how long the rep has been with Tricare.
 
Good Luck!!

I am TriCare standard. My husband is retired Air Force, but I have Health Ins. through my job. I asked my civilian Dr. for a referal to Madigan for Gastric surgery. He did it, and I have been going through pathways at Madigan.

Hi, I have not heard of your surgeon, but wanted to say HI, I am just a bit North of you, in Marysville. It is rare to see people up this way!!!

I am seeking a revision from my original surgery in 2006. I had / have Tricare Prime as well. My husband is retired Navy.

For the original surgery in 2006, I used a civillian doctor that accepted tricare. He was AWESOME, and if he would not have retired, I'd be using him for my revision as well. But I am going to Madigan for my revision. I feel I am in excellent hands at Madigan as well!

Anyways, so for the civillian dr. I was approved in one day and it was so easy. You have to be 100 pounds overweight with a co-morbidity, such as diabetes, or 200% over your desired weight. They use the metlife weight charts to determine what you should weigh.

So, as long as your doctor accepts tricare prime, as long as you meet the weight requirements, you should receive your approval with no problems!!

GOOD luck to you!!!!

Hi!  Thanks so much.  Lisa has it right.  It's 100 pounds over with co-morbidity or 200% over.

I should be approved for the intial consultation with McMahon who is through Swedish in Seattle and I believe it is a Center of Excellence.  I spent an hour and a half on the phone last week trying to find someone who took TriCare and finally called TriCare themselves and they helped me find someone.  :)

I have sleep apnea and was pre-diabetic a year ago...I'm more than 100 pounds over.  So, I'm hopeful it will be a pretty easy approval.  The lady from TriCare that I talked to on the phone said to make sure to send everything in the first time b/c they are denying a bunch of them b/c people don't get everything sent in and then for appeal it can be up to 60 days!  Eek! 

I'm new to the process.  I have a seminar to attend on the 25th and then can make the initial appts after that.  :)

SuSu ~ Do you have any tips about what exactly to send in for the approval? 

Lisa ~ I'm in Lake Stevens!  :)  Are there any support groups up this way that you know of?

Nope, sadly, there are no support groups this way...(that I know of).

I had my original surgery at Swedish in Seattle. I had NO problems at all with the care there, so you should be in awesome hands hospital wise!

It is great that you found a surgeon that would take Tricare. I originally was going to go the civillian route, but could not find a single surgeon that would take Tricare. I am actually glad (for me) that I did not find one, for I feel I am in great hands at Madigan, but I have to say, the Madigan process is a long one.

Well, congrats to you! You should be having your surgery in no time. Like I said, my approval took just one day!

Maybe we'll have to start a support group!  :)

I know when I was calling around trying to find a doctor, there is NOTHING up here in Everett.  I was surprised.  My doctor is out of Seattle and Issaquah. 

I have heard wonderful things about Madigan - and when I was calling around I found two different offices that recommended them.  I'm thankful that I didn't have to go all the way down there though b/c with two young children, a business to run and a husband that works a lot - I think that would have been really hard for us to manage.

YAH to having health problems that get us approved easily, huh?  LOL 

It was frustrating that no one takes TriCare though.  These are people that served our country!  My husband was in the CG for 20 years.  One of the offices I called said they pay too low.  I think something is going to need to change - b/c I notice more and more doctors dropping it. 

Yes, we just may have to start our own support group.

I hear you on the commute to and from Madigan, it sucks. Fortunately, my oldest son (15) watches my other three (9, 7, 1) for me there at Madigan while I am in my appts. It is not ideal, but it works. They actually love to go, they feel like we are going on a road trip to somewhere fun. LOL

Yeah, every single surgeon I called immediately told me no the second they heard Tricare. Sad indeed!

I am glad you found a good surgeon and are well on your way!! WOOO HOOOOOO!!! 

Hello, LisaAnn:

I'm new to this forum and am hoping to have my surgery done sometime in Sept at Virginia Mason.

What is>>>Seeking revision from VBG to DS?

Queenie

I live in Ga.  My husband is retired Army.  I had Lap-Band last Sept.  Tri-Care accepted very fast.  My first appointment with my Dr. was in June and I had my Surgery in Sept.

It went Great.  I have gone from a size 24 to a size 8-10.  And I feel Great.

Just remember to take your Vitamins, Protein, and Liquids.  When you come home just sip, sip, sip, walk, walk, walk.

If you would like, I will be your Angel.

Deborah