Question:
Does tricare cover lapband? I have been refered to a surgeon in greenville NC

   — yk4sw (posted on October 18, 2007)

October 18, 2007
As of now, Tricare does not cover Lap-Band. They covered the surgery up until the end of 2004. My husband is active duty air force and I tried many times to get the surgery covered. I think sometimes you might be able to pull a few strings, but it depends on the Tricare office you have to go through. Where we are in Texas, they do not want to pay for you to get most anything done. I have polycystic kidney disease and was not a candidate for RNY. We did self pay. It was $12,000 for a wonderful doctor of my choice in the San Antonio area. I am 7+ months out and have lost 90 pounds. I don't regret paying out of pocket one bit to get good care and have it done without having to jump through hoops. I wish that Tricare would at least offer to pay back half of the surgery cost if the patient is successful with it. I know that my primary care physician says that I am an oddity when it comes to Lap-Band and weight loss, but I do not think that that is true at all, especially when you read profiles on here of people who have had Lap-Band. I hope that you are able to achieve your goal of having the Lap-Band one way or another. I do know that when I first looked into, they told us to check out Wilford Hall (kind of bigger hospital on Lackland where they do "experimental" stuff for military personnel and dependents). Maybe you could contact one of the bigger military hospitals on the east coast and see what they have to say. I know that the naval hospital in Bethesda is pretty up to date with that kind of stuff. If you have any questions, just let me know.
   — fluphystuph

October 18, 2007
I am a retired Army dependent, I have Tr-Care as well. In 2003 they approved my Lap Band but as previously stated they do not cover them any longer. I am having a Revision on Oct 29. My experience with the band at first was great. After 4 years I developed Gastric Reflux really bad my band has nit been filled in almost a year. The thing I was not told then is the band will start to grow into your stomach after so many years and the reverse or having it removed is not exactly true in some people. Tr Care would not pay to have mine removed but will pay for th gastric bypass which doesn't really make since to me. I was told by Tr Care that they stopped covering the band because it was too many people needing to have them removed after a few years. I wish you luck in your journey. Carolyn
   — MSCDALEX

October 19, 2007
I am Ret. USN Dependant on Tri-Care. I had Laparoscopic RNY on August 27th 2007. My surgery was approved very quickly and with no appeals or phone calls between me and the insurance company. As of this time they DO NOT cover Lap-band. Good luck. Joanna J
   — Joanna J.

October 19, 2007
No, TriCare Prime does not cover the lap band. As far as I know they only cover the Roux-n-Y (Gastric Bypass). Therefore I originally opted for the RNY, but after going to a seminar with Dr. Cribbins in Dallas I became very interested in the Vertical Sleeve Gastrectomy. My surgery is Oct. 25. I have to pay $14,500 which was also the cost of the Lap Band. I'll keep you posted. TriCare will pay for all the pre-op requirements if you get referrals from your PCM. I ended up paying for the pysch. eval. TriCare will pay but it takes time to get approval and I had a date and didn't want to bump my surgery date. Pat
   — pjennjr

October 19, 2007
I know you are determined to stick with the lap-band, but I wanted to just take a second to let you know that Tri-Care does cover 100% on the RNY. I had mine on 24 Aug 06 and couldn't be happier. I went from a size 22/24 and am now wearing a 7/8 bottom and 10/12 top....I had absolutely no problems, but did a lot of research on surgeons before choosing my doctor. My approval was quick and painless. Tri-care was wonderful. I started the process in Mar 06 and had surgery in Aug 06. Good luck with everything!!!
   — andrealej