Question:
I Have Tricare Prime and am waiting for my appt. with the doctor. For Co-morbidities

I am pre-diabetic and have arthritis in my knee. I am well over the 100 lbs overweight but still worry that I won't get approval. Has anyone had any trouble with Tricare.    — [Anonymous] (posted on January 16, 2002)

January 16, 2002
I have Tricare Prime and although the handbook states that the criteria is 100 lbs. over, my surgeon qualified by BMI. And since mine was done at the Naval Hospital, it was up to the surgeon if we qualified. We didn't have to call Tricare to get approval. But I have heard that they are a lot better than they used to be. Good luck on your new journey!!
   — Cheri M.

January 16, 2002
I have TriCare Standard and had no problems w/them. In fact, they approved me after 48hrs. I have some of the same co-morbs you do. Rheum. arthritis, gestational diabetes, GERD, high triglycerides.
   — Karen B.

January 16, 2002
Hi, I have TRICARE Prime. If you are having your surgery done at a military hospital, Tricare has nothing to do with it. Tricare is only used for when you go off post for any procedure. I'm currently going off the military base for my WLS and dealing with Tricare. So far they have been good about authorizing my appointments quickly because I get my old surgeon from the military base to write my referals for all my visits and I don't even deal with my PCM. I get him to write my referals "asap" so they will be processed within 72 hours and I don't have to wait 30 days inbetween appointments. As far as getting approval from Tricare for the actual surgical procedure, that hasn't been submitted yet, but I don't expect any delays and they have to give you an answer within 30 days anyway. If you want to know more, feel free to email me.
   — Tina P.

January 17, 2002
I have Tricare Prime and was approved in a matter of maybe two days.. and I think those days were weekend days. I have arthritis as my main comorbity. I have had a wonderful experience with Tricare. My only advice would be to make sure you stay within the network of providers. I think my hospitalization was $11 a night. Feel free to email me if you have any further questions.
   — Pamela W.