Question:
Tri Care Prime

I would like to know if there are any other people living here in San Antonio,Tx who want to get the lap RNY done. This whole Tri Care thing is confusing and I would love to talk to someone who is going thru or has gone thru the whole Tricare approval ordeal!! Thanks!! :)    — sally_ogin (posted on July 5, 2007)

July 5, 2007
I don't live in your area, but I had my open RNY paid for by Tricare Prime (active duty military) and there was no ordeal at all. I talked with my PCM about the possibility for the surgery and he sent me to a surgery consult with Dr. Warnock in Wichita Falls. After my initial visit with him, his office submitted everything to Tricare and the approval came to them the following week. They called me to schedule a date and WHAM, everything was done. No muss, no fuss! I don't think Tricare differs from state to state, it's all military health coverage and goes by region. Since I'm in Oklahoma and you're in Texas, we're probably both in the South Region, covered by Humana Health. Here is a phone number and website for it: TRICARE Regional Office, South 1-800-554-2397 or 1-210-292-3256 www.tricare.mil/trosouth Good luck! Donna
   — Donna Jensen

July 6, 2007
I have tricare prime and had no trouble at all getting my approval for lap RNY. I dont live in san antonio, but i am in texas (abilene, stationed at Dyess AFB). I did originally have to gain weight to qualify as a candidate, but once i reached a BMI of 40 all i had to do was get a referral from my primary care doctor on base. I did struggle with my doctor to get that referral, but i believe it was because he didnt think i needed the surgery. I was relentless though and continued to gain the needed weight to qualify, and then finally my primary doctor moved and I was under the care of a new physician, who had no trouble giving me the needed referral. From there, it was fast and easy! If your BMI is at least 40, you shouldnt have any trouble....unless you happen to see a doctor that has personal feelings about the surgery and insists you can do it on your own. If that happens, just keep rescheduling, which is what i did. Eventually they will get tired of seeing you and just give you the dang referral! Once you get that referral, you'll be amazed at how soon after you'll be having surgery. Best wishes to you!
   — kuppykake

July 7, 2007
I have to agree with the two previous posts. I am actually at Malmstrom AFB, Mt and I had no problems getting my procedure approved through Tricare Prime (also active duty). Once your PM refers you to the surgeon it should be relatively easy. I saw my PM on May 7, saw the surgeon on May 25 and had my surgery on June 25. I definateky think you should contact the Tricare office for your region. Good Luck!
   — originalmrssims

July 7, 2007
I live in WA and am also Tri-Care Prime (active duty) and had no problem being approved for my open RNY on 12/27/06. I met with my surgeon on November 2 and had my surgery a little over 2 months later (my surgeon required a battery of tests that took a little while to complete). But it's SOO worth it, even if you do have to do a little "fussing" :).. I'm not too sure about the lapband though, you may need to ask Tri-Care if they cover that vs RNY. I was told they didn't. Good luck!
   — airbear762000

July 9, 2007
You just have to have a doctor and hospital that will take it, our hospital soes we are a hour and a half I think from San Antonio we get alot of patients from there and south Texas because we are one of the limited number of hospitals taking it.
   — DonnaB.