Question:
I need help with Tricare Europe. I can't seem to get anywhere with anyone.

Please Help. I am 33yrs old, 5'3" 240lbs. My bmi is 42.5. I was denied two weeks ago for lack of comorbidities. I turned in my appeal last week, and was called today and was told if I do not have any comorbids I will be denied again. I was told I do not meet the 200% over ideal body weight she said I need to weight 256. I will be tested this week for sleep apnea. I'm also making appts for every ache and pain. What else can I do? Anyone have any suggestions for me? I'm feeling helpless over here in Europe...    — Jillisa R. (posted on January 27, 2004)

January 27, 2004
go to the tricare website and do a search in the handbook on "obesity". print that out and send it to them. if you have a bmi of 42.5 then you should qualify WITHOUT any co-morbs. how did she come up with 256 for what you should weight? tricare uses the met-life height and weight scale to figure your bmi(you can go to the met-life website and find this too). they use med. frame(no matter what your frame size) and use the average for the weight for med. frame. this is what your normal weight should be. then mulitply that by 2...that is 200% of you ideal body weight. remember the doctors are there to treat you...not to know your insurance. the rules on treatment for obesity change weekly it seems. the best thing to do is to print out the page from the website and send it to them or take it to your pcp.
   — franbvan

January 27, 2004
Jillisa, My best guess would be that maybe you should try contacting Dr. Wiener in Germany. His office may be able to assist you. Here's the contact info: Prof. Dr. Rudolf A. Weiner E-mail: [email protected] Phone: 0049-69-6605-1199 Fax: 0049-69-6605-1530 Department of Surgery, Section for bariatric surgery Krankenhaus Sachsenhausen Schulstr. 31 60594 Frankfurt Germany Other surgeons that I know of in Europe: Philippe Topart, MD E-mail: [email protected] Phone: (33) 2 98 34 72 19 Chirurgie Generale, CHU Brest, F-29609 France and my surgeon: Dr. Aniceto Baltasar (photo) E-mail: [email protected] Board Certified by ACS (American College of Surgeons) Member of ASBS (American Bariatric Society) and IFSO (International Federation of Surgery for Obesity) Founder and President of SECO (Spanish Surgical Bariatric Society) C/ Cid 61 03803 - Alcoy Alicante, SPAIN Phone: +34-96-533.25.36 and +34-654-06.40.93 FAX: +34-96-533.25.36 and +34-96-533.04.00 http://www.drbaltasar.com (in English and Spanish) http://www.seco.org (in Spanish) www.bodybybaltasar.com Blessings, dina
   — Dina McBride

January 27, 2004
I had the same problem. I am in Hanau Germany. I actually ended up disenrolling in Tricare Europe, flying back to the states (my home of record in Idaho) and enrolled in TriWest. I was approved in 48 hours, no comorbids, and my BMI was the same as yours. If you can afford it, that's the way to go. Research your surgeon before you go and have a phone consult to determine your eligibility. I flew to Boise, got all the pre-op testing, got the approval, had the surgery and made it home in about 60 days. I don't know if that's realistic for you. It was hard for me because I had to take my kids with me and my husband was (and still is) in Baghdad. They paid for everything except the psych eval. I had a $50 co pay on the hospital stay and something like $19 on radiology, then also $25 for the endoscopy I had done pre-op. Plus of course the airfare was the worst of it. Sorry to be so long winded, but that was how I got it done. TriCare Europe is very hard to work with.
   — Jennifer H.