Question:
Hello, All! I am wondering what my chances of being approved through Tricare Prime

Wondering what my chances of being approved through Tricare Prime are being 5'2 and weighing 212lbs. I was denied the first time, but PCP had put my weight at 200lbs. I also have hypertension. Any help would be greatly appreciated. Thanks, Karen    — Kalena B. (posted on October 7, 2003)


October 6, 2003
Karen, I have personally just battled with Tricare, you can e-mail me if you like and I will help you, I had similar weight, (borderline by their standards) and was denied the first time. I was approved after appeal, and my surgery date is Oct 17, my e-mail address is [email protected],,looking forward to hearing from you!
   — shawn R.

October 6, 2003
Hi Karen, I was approved in 6 days with Tricare Prime. I am waiting for my surgery date now. I did have a well documented diet history, all of the medical tests that they require and comorbidities of high blood pressure and diabetes. But they would not send ME an approval letter. They would only fax or send it to the doctor. Good luck - It will hapen for you.
   — Char L.

October 7, 2003
Karen, I had absolutely no problem getting approved through Tricare. Actually, my PCM wrote a letter of medical necessity, Tricare then authorized me to see a surgeon they recommended and then his office did the rest. Was approved in one week. Please email me at [email protected] if you would like me to help you. What part of the country do you live in? I'm in So Cal and seems everybody from San Diego to north of LA gets approved asap. Maybe the Tricare office for this region is 'easy', don't know. Today I'm seeing a plastic surgeon that Tricare authorized via my PCM's recommendation (I told my PCM who I wanted to see and he related it to Tricare). Hopefully, it will be as easy to get the plastics approved but I'm definitely not holding my breath. Let me know if I can help you.
   — Vicki S.




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