Question:
200% over ideal body weight
and yet i cant get someone from tricare prime to understand. they are trying to tell me that 200% is the percent plus the ideal body weight. i have no comorbs so i was denied. i am appealing on this basis of being 200% over ideal body weight if anyone else had this problem please email me and tell me how to get the point across. thank you in advance. — tacy T. (posted on July 22, 2003)
July 22, 2003
Let me see if I got this right. My weight (for my short height) should be
around 130. 130 x 200% is 260. But I weighed 319. So I should have been
about 250% above my ideal weight? I'm not sure what your weight should be
or what you weigh now. Perhaps I misunderstand your question?
— Danmark
July 22, 2003
I spoke to a person at Tricare. 200% above your ideal body weight is the
ideal body weight for your height at 200% over that. So, let's say your
ideal body weight is 100lbs (my math sucks so I keep it simple)You would
need to weigh 300lbs to qualify. I would go to the tricare website and
pull off the information directly. Then give them a math lesson.
— dimpkd
July 22, 2003
are you sure you have no co-morbidities?? Take a gander at the list on my
first profile under sharon brittain you may have some you are not aware
of!! Also, there is an insurance letter there you can use that may help
you. Let me know if I can be of any help! :~)
— Sharon m. B.
July 22, 2003
i'm tacy angel... in the tricare handbook(chapter 10.31) it states one of
the ways to get wls is to be 200% "of" your ideal body weight not
200% "over". i'm using tacy example here. 100% of $1.00 = $1.00
so that would mean 200% of $1.00= $2.00. in the matter of being 200% of
her ideal body weight, that would just mean 2 times her ideal body
weight.not 2 times over.
— franbvan
July 22, 2003
Could you please restate this using lbs and BMI (or height/weight)? The %
thing is confusing!
— Chris T.
July 23, 2003
i would like to thank everyone who has sent emails or wrote a response to
me. to help out i weigh 278lbs and am 5.5 according to the metlife i should
weigh 134 for my height and bone structure. so 200% of 134 is 268. if
anyone thinks this is wrong please correct me.
— tacy T.
July 23, 2003
Traci, again the handbook say 200% 'OF' your ideal weight. I was told that
they take you height, find the ideal weight of a medium size person and
multiply it by 2===equals 200% 'OF' the ideal weight.I was also told by my
Tricare person that the BMI is also considered, and that it is in how the
doctor states you problem to them. If the weight is affecting you daily
living, and aches,pains, or co-morbs. I started at 5'6" and 251 with
NO co morbs, BMI of 40.5 and I was approved. I was not 200% of ideal
weight- if that was needed I would of had to weigh around 280#. Soo... Good
Luck, email me if you have any questions.Jan
— Jan S.
July 23, 2003
I was also denied by Tricare, you need to have your letter in your hand and
appeal what they denied you for, I appealed and won, if you go to my site
you will see why I was denied and what I did to appeal. If you already have
your letter and you want your answer quickly you have to act quickly you
have three days from the time you get your letter to send in an expedited
appeal and they have three days to answer it. Otherwise you can take 30 to
appeal and they can take 30 to give you an answer. I think if you were
denied just for not having co morbidites then you should hit them with the
things that your family has that are weight related, problems that you do
have that may lead to these co morbidities that are listed on there
website. Good Luck to you. You can win on appeal if you have your ducks in
a row and quacking as someone told me!
— S C.
July 23, 2003
Be sure and look at Sharon Brittains site. I found co-morbs on there I
didn't even know I had. Her site is phenomenal and is/was a GREAT HELP to
me. I think I found over 50 co-morbs that I had and didn't even think i had
but a few. Just my 2 cents worth!!
— bufordslipstick
July 24, 2003
again i thank you all. i am faxing my letter over tomorrow. i pray that i
get an approval i thank everyone for helping me.
— tacy T.
Click Here to Return