Question:
Will I have trouble getting tricare to cover the surgery?

   — ashley-clark (posted on January 20, 2008)

January 20, 2008
I had no problems what so ever getting approved with Tricare. They don't require all that much. It's a covered benefit with them if you're BMI is high and you have any comorbidities.
   — Tomi D.

January 20, 2008
Ashley, I have a friend (I am a nurse) who is also a nurse and used to work for Tricare in their approval area for claims etc - and she told me that a lot came through and were approved - I don't know what your BMI is and what Tricare's criteria is. I had RNY on 12/19/07 at Eisehower Army Medical Center in Augusta GA - I guess there are several military hospitals in the country that are "specialty" centers for WLS - this is one of them. Thereare 3 surgeons doing them here, and they have done over 400 at this hospital. There is a support group that meets monthly in the hospital. I didn't have to go through Tricare at all - I just had my PCM refer me to surgery for WLS and went from there. I went in and had it done and didn't deal with the insurance company at all. My surgeon was great and trained in Boston - I have total faith in him!! He is going to do a tummy tuck on me when I get all my weight off - totally covered, not having to deal with Tricare at all - hope that helps. Joanna
   — machre

January 20, 2008
I have Tricare Prime and they were wonderful! Extremely fast approval too. They didn't require any 6 month diets prior. As long as you meet the requirements of weight to lose, you'll be okay. I paid a total of $25 for my surgery including hospitalization.
   — Cindy H.

January 22, 2008
Hi ! I am dealing with tricare right now. They are approving the 6 first visits with the surgeon, then I have to get approval again. But they do cover the RNY procedure-if you have an ailment caused by being over weight...such as high blood pressure, diabetes, etc..and you are 100 lbs over weight. I have tricare standard and am in upstate NY. They do not require a doctor monitored diet for any length of time and are really quite easy as far as their criteria is concerned. I hope you have as good a luck as I have !
   — gpcmist

March 1, 2008
Ihave tricare and they would not approve for me to have the gastric sleeve, but they did approve the gastric bypass, my surgery is scheduled for the 10th of march......can't wait.....Good luck to all of you.......Dianepic
   — dianepic