Question:
does tricare cover gastric bypass surgery?

if so..does tricare pay all of it or does the patient have to come out of pocket?    — latisha J. (posted on May 10, 1999)


May 10, 1999
i have tricare prime. i had a gastric bypass. but, i had it at an army medical hospital (eisenhower army hospital in augusta ga.) if you are an active duty spouse and live too far away from a facility that performs this surgery then they will cover it if your pcp requests the surgery consult. they require some pre-op testing and pre-approval from their tricare main office, but i do believe it is possible. However, i was told if you live within a certain radius of a military hospital that performs this, then your pcp will have to refer you to general surgery at that military hospital. my hospital was 250 miles away and thats where i was sent. but i'm not sorry, it is a very modern, efficient teaching hospital. i loved my surgeons and hospital personel. i hope this answers your quesions. feel free to write me at [email protected] or visit "my wls story" at http://www.geocities.com/fashionavenue/ stage/1853/wls.html
   — Linda O.

May 10, 1999
Depends on what type Tricare you have on your cost. I have Tricare Prime and had the surgery Sept. 25, 1998. It cost me about 60 or 70 out of pocket. I had the surgery had Ft. Stewart at the Army hospital by and excellent Army surgeon Email me directly at [email protected] and we can talk more about your options. I would be glad to answere any and all questions to be best of my ability.
   — Dana B.

May 10, 1999
Hi I'm in Ft. Stewart GA. I had RNY don 11-97 by a military surgeon the only thing it costed me was the daily hospital fee. Now if your trying to go to a civilian dr. I have no idea have you checked with general surgery to see if they offer it?
   — penny S.

May 10, 1999
Yes, Tricare does cover the bypass. I am only pre-op but have researched quite a bit. I have tricare standard, and they will cover it 80%. Under certain conditions. I am not sure how much Prime pays, but I do know they too cover it. Good luck to you.
   — Patti W.

May 11, 1999
Hello, We're Army! I have Tricare Prime. Yes, they are taking care of my RNY surgery. I'm paying only $11.00 a day out of pocket. That's it! Good Luck. CBrady
   — C B.

May 15, 1999
I have TRICARE Standard which is basically old CHAMPUS and yes I got an approval from them. I was scheduled to have surgery on Monday May 10th but could not get it done because my weight keeps fucuating around the range that is required by TRICARE to be eligable for them to pay. The surgeon does not want to risk doing the surgery and then have it denied in the end because i was 10lbs under the over weight requirement of 100 lbs. or 200% over my ideal weight. Now my schedule at work is so full that it will be next year before I can schedule anytime off to possibly have the surgery. But, yes as far as I know TRICARE does pay!
   — Sherry H.

June 13, 1999
Yep! I was approved by them too. Easy approval. I am due to have the laparoscopic gastric bypass by Dr. Rutledge on 7/12!
   — terri S.

July 21, 1999
Hello we are USMC and I am having WLS August 3rd at Ft Stewart, Ga Army Winn Hospital. ALl I have to pay is 10.45 a day! Can beat that for a $40,000 operation!! The first time I saw my surgeron was in June and I am having my surgery in August! They work fast and are very good to me! :)
   — Nicole S.

February 19, 2000
Yes Tricare Standard will cover lap. gastric bypass surgery. I had mine done by Dr. Nguyen at UCDavis in Sacramento on Jan 10, 2000. I have not got the total bill yet, but I suspect that all that I will have to pay is the room charge.I am down 40 pounds and counting. I reccomend that you make contact with your local local Tricare rep. and use them to help you. Make sure that when your MD submits your letter for approval that you have you weight, height and body frame included.
   — DENISE S.




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