tri care and wls

ghostorchid
on 3/1/15 10:38 am

does anyone have any experience in  using tricare to cover WLS?

MajorMom
on 3/1/15 5:58 pm - VA

I had to use civilian insurance to cover mine since I had chosen the duodenal switch, which Tricare doesn't cover. My understanding is that they are pretty backwards as far as qualifying with "more than 100 pounds to lose". In my case I was 36.8 BMI but didn't have 100 pounds to lose. I hope they have updated their qualifiers and maybe even the surgeries they cover. The last I heard they covered the bypass, sleeve and band. Good luck and keep us posted.

--gina

5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
                                 ******GOAL*******

Starting BMI between 35 and 40ish? 
Join us on the
Lightweights Board!
DS on Aug 9, 2007 with Dr. Hazem Elariny

Jody ***
on 3/1/15 10:46 pm - Brighton, MI
RNY on 10/21/08 with

I thought Stacey had hers covered by Tricare.  Perhaps she should put this question on the FB WLS Lightweights page?

 

HW-218/SW-208/CW-126/ Lowest Weight-121/Goal-125 - hit 8/23/09/Height-5'3"

Regain 30 lbs from 2012 to 2016 - got back on track and lost it.  Took 8 months. 
90+/- pounds lost      
BMI - 24 or so
Starting BMI between 35 and 40ish? 
Join us on the Lightweights Board!

julia4mom
on 3/2/15 4:01 am - Lynn Haven, FL

I had my surgery on January 28th and it was covered by Tricare.  I was 215 at my 1st doctor appt., with a BMI of 38, I am 5' 3", I was approved within one week of submission.  I did have several morbidity, pre-diabetic, high blood pressure, asthma, high cholesterol.

Hope this helps, my goal weight is around 140 so I did not have 100 lbs to lose.  I am currently 182!!  I am so happy I had gastric bypass.  Tricare does not cover any other WLS

 

    Those who say it can't be done, should not interrupt those of us who are doing it

Navychic
on 3/2/15 4:51 am
RNY on 02/09/15

Yep just had mine done under tri care also early this mth.  Heres a link to what qualifies: http://www.tricare.mil/CoveredServices/IsItCovered/Bariatric Surgery.aspx?p=1

but basically no active duty.  40% BMI & above or 35% BMI with a comorbidity should qualify.

 

Good luck!

I'm Jo   HW 245, SW 236, CW 151 Yeah (Normal BMI!!!!)

M1=213 (-23), M2=201 (-12), M3=186 (-15), M4=175(-11), M5=166(-9), M6=157(-9), M7=153(-4) 

        

    

tracik3
on 3/2/15 6:39 am

I had consult 2 weeks ago and he said Tricare is actually on of the easier insurance companies to approve. I just have not decided if I want to do it yet. UGH

I have also had 2 people tell me that there will be some changes with Tricare in there new year (Oct). It could be good or not good. They could make it harder to get approved.  Or not.....they could include sleeve.

ghostorchid
on 3/2/15 1:16 pm

thank you  for your help

Most Active
Recent Topics
10 years today
Linda B. · 1 replies · 389 views
12 Year Surgiversary!
Lee ~ · 1 replies · 509 views
Post Iron Infusion Dizziness
Jennifer K. · 0 replies · 566 views
Still kickin'...
STLfan · 0 replies · 579 views
×