Question:
TriCare Prime, help choosing a PCP and Surgeon

I would like to hear from people who've had Gastric Bypass with TriCare if i should look for one of the doctors on base or should go outside to a regular hospital? Also me and my husband will be in Fort Gordon, GA so any suggestions will be appreciated. Thanks in advance for your answers and thanks to all the people who answered my other question "TriCare and qualifying for GB"    — Yanelys83 (posted on March 20, 2006)

March 20, 2006
Hi. I am not in Georgia. I had my surgery in VA. Tricare was wonderful. I saw a doctor who accepted Tricare Prime. It was fairly easy and painless. It helps if your PCM has a record of your diet attempts. I had a friend who went through a base doctor and she was required to do a 3 month diet prior to surgery, I on the other hand did not have to do that due to my recorded history. Getting a military doctor all depends on availability. If there is high demand for surgery in your area due to the war, then you will get an outside referral. If you get a military doctor I would say that you should feel comfortable. This surgery type is usually the only surgery they do (they won't operate on someone's knee one day and do gastric the next). If they refer you out to a civilian you can also feel comfortable in knowing that any doctor who has 1 complaint against them cannot be in the Tricare referral system. Either way, Tricare is fairly easy compared to most insurances. Good luck and if you have any further questions, don't hesitate to email me! : )
   — Peachymom

March 20, 2006
Hello. I had my gastric bypass (lap. RNY) August 2, 2005. My hubby is active duty U.S. Air Force. I got a refferal from my primary care manager to surgery. It stated for me to be evaluated for WLS and if I qualified to be accepted in their clinic. I was required to go to a 3 hour seminar that explained everything. After the seminar, you met with the head of surgery and was told if you qualified or not. Then you were put on the waiting list and given a list of requirements that needed to be done before you got your surgery date. Once you were done with the requirements, you could opt to go to a 'outside' surgeon that accepts Tricare for your WLS. I had an excellent experience at Womack Army Hospital. I would highly recommend it to all. I can let you know that all bases, posts, and regions are different regarding WLS and Tricare. You really need to talk to a Tricare specialist or talk to a few surgeon's offices in your area and ask lots of questions and take notes. I know it is a lot of work. This surgery is something that 'we' (some much more than others) have to research and find surgeons, get approvals, and do tons of requirements to get the surgery. I can say, from my experience, it is SO WORTH all the hard work you have to do prior to surgery. Good luck : ) Smiles, Jenna
   — jstatkus

March 20, 2006
I have TriCare standard, I have been battling for a year, I can only have a DS, do to a service conected condition. and that they arbitrailly decided to exclude from coverage on 4/20/2005, Only the Military,and its retired are denied the DS wls, Medicare,Champva, and Congressional health plans have it. My appeal is before the General Granger. under SEC of Health Tricare,DOD, thanks to my Congressman. in 38 years of entitlement tricare has never paid a dollar of claims.
   — walter A.

March 20, 2006
Planing on wls , check out the DS, visit the DS forum, its harder to get, but easier to live with and it is going to be available shortly to the military again, see my post above.
   — walter A.

March 21, 2006
I am about to have my surgery on April 18, and I have Tricare Prime. We are stationed at MacDill in Tampa. I can only tell you what I went through. I went to PCP in July and talked with her about wls. She was completely supportive, and told me what Tricare requires. I had to have 6 months of diet history, a sleep study, a psychological eval, see a nutritionist and your bmi must be 40. After the 6 month supervised diet, she sent in for my refferal to the surgeon. I had to go to a civillian surgeon bc we had no surgeon on base. Tricare was great through my whole process, and from what i gather from talking to others, they are incredible compared to other insurance companies. Good luck and you can email me thru my profile if you have any questions. Good luck Jennifer Barnett
   — jenzstory

March 22, 2006
I'm in Washington and used a civilian doctor with Tricare as my insurance. I had no issues with them at all. I did have to start with my PCP and get her on board but once that was done...it was smooth sailing. If you have any further questions, please visit my profile and email. Good Luck!!! Judy M.
   — J.Bug