Question:
I have tricare prime insurance and have been approved for this
WLS. My question is regarding the reconstructive surgeries that may be needed later on down the road. Does anyone know what, if any, surgeries they do cover and under what situations. I have a heard alot of conflicting statements and just wanted to ask. — brandilw (posted on June 1, 2003)
June 1, 2003
Hi there... I have Tricare Prime and live in San Diego. I had the RNY in
February, so reconstructive surgery has been on my mind as well. According
to the Tricare Handbook on procedures, a panni will be approved if another
condition exists. (my wording isn't that great, go to the tricare site)
If you have a hernia, severe rashes, chronic back pain etc. That being
said, I think the ease in which it is approved depends upon the savvy of
the requesting physician, and where you are having it done. San Diego has
a plastic surgery clinic at the naval medical center. It probably will be
easier to get it done at the medical center, then going through a physician
on the outside. (cost based) However, you might have to wait longer for
the procedure due to deployment, emergent cases etc. My two cents worth.
I have found with Tricare, that they stand by their handbook, and if you
meet their requirements, it is a breeze. Document back aches, rashes etc.
It will make it easier on you.
— dimpkd
Click Here to Return