DENIED

Linda, you make a very good point. Appeal letters for a denial are useless til you actually have the denial letter IN front of you stating the reason for denial.

Sarah, as hard as it is to wait, you really should until you have a copy of the denial actually IN hand.

Liz

Tricare couldnt really tell me . My doctors office said beause of my BMI under 40 and just PCOS. But  I have met ppl here they got approved with PCOS and BMI under 40 .

You will get a denial letter stating the exact reason...hold off til it gets to you in the mail...it may take a week plus esp this time of year. But until you see it in writing, you are shooting blind.

And like I mentioned, have your doctor or surgeon check for other possible co-morbids.

Liz

I know its hard to think Tricare has denied you.  I did get approved with a BMI under 40 and PCOS as my only comobidity, but I had a history of other stuff.  I had a history of high blood sugar, although was stable since I had gotten pregnant.  I had a long history with Tricare with many infertility issues, and IVF, and being on Metformin for a little while.  So I dont know if they looked at my history as well when making the decision.   I agree in the letter dont make it personal about appearance, or smoking.   They do not want to think that you will be asking for plastic surgery later, or going back to smoking after the surgery.  Although I hate smoking, I would urge you to stop now, that is one major step to becoming a healthier you.    Good luck.

Aimee

I hope you can get an answer out of Tricare. Do you have 100 pounds to lose and is that stated in your records? Sometimes that magic 100 pounds is all they look for. Bureaucrats! 

--gina

Are you Prime or Standard? I hate to say it but sometimes this has alot to do with it.

I am Prime

 My doctor had 2 Tricare denials before mine was approved.  I think the difference in my case was the previous weight loss attempt documentation.  My primary care doctor wrote a letter that I had been on Weigh****chers and have tried several other attempts.  In addition to the letter, we sent a copy of my weight loss and subsequent regain from weigh****chers website.  If you go to your log in on WW you can create a graph.  We sent mine as part of my documentation.  Honestly,  I think my doctors office is going to have the other two ladies have their PCPs write letters testifying to previous weight loss attempts and then resubmit an appeal.  I would recommend that.

Thank you. I Know what u mean I printed and senty weigh ins during weigh****chers with my letter of reconsideration so I guess I will see if that won't work I have to sit down with my PCM and see what we can do