Question:
Has anyone out there been approved for a T.T. with Tricare Prime

   — Christine H. (posted on April 26, 2004)

April 26, 2004
i have tricare prime and just had a full tt, hernia repair and inner thigh lift 6 weeks ago and tricare paid for it. i had a long history of skin tears and rashes under my stomach and inner thighs. make sure EVERY single time(even if you think it's not that bad) to go to the doctor so that they can write it in your medical history. tricare will not pay for it if it is only to remove the skin. for them to pay it must be for a medical reason like rashs, skin tears, major break down of the skin, back aches ect...if you call tricare and ask them if they cover it they will tell you no. you must go to the tricare website and look up reconstructive/plastic surgery. i printed out the page with all the info on it and took it to my primary doctor on the base and also took it to the surgeon. i did this also with my wls surgery to get the referal. the base doctors are there to treat us and because tricare changes so much it is important they they know the guidelines so that you can get your referal. if you read on the website it says that anything on this site overrides anything that is in written form. meaning that at the website you get all the new changes and guidelines that you must meet for surgery and the referal. if you meet the guidelines they have to give you the referal so that is why i took the guidelines with me. good luck to you
   — franbvan

April 27, 2004
I haven't done battle with Tricare for my T.T. yet because I'm not ready at this point. Wanted to let you know, though, that I have met several people on this site who have gotten them to do their T.T. Basically, like the other poster said, it depends on documenting problems you've had with the skin. But also, depends on availability of military plastic surgeons in your area. Unless you have a hernia, you may be pretty far down on their priority list. I'm sure you know how it is when military health care resources are stretched thin--and they're extremely unlikely to allow you to go on the outside too, unless you have serious complications from the skin. My military bariatric program coordinator said she'd NEVER seen anybody get approved to go on the outside for PS. And she'd dealt with over 600 patients. Said that such cases are evaluated individually, so documentation is crucial. Go to the doc if you get a zit or whatever. You may feel silly, but it will go into your medical record! Good luck getting approved! Christie, 7 mo post, -175
   — christied

April 27, 2004
i had all of my reconstructive surgery done by a civilan doctor who accepted tricare.
   — franbvan