Question:
Does anyone know if Tricare Prime covers this procedure?

   — Janis R. (posted on April 19, 2003)

April 19, 2003
Yes it covers it.. I just had surgery on March 17th. I was approved in a weeks time.. Depending on which area your in you might need a list of diets you tried in the past few years... It has to be medically necessary..
   — Catherine B

April 19, 2003
Hello Janis - I have TriCare Prime (my husband is in the military) ...not only do they cover the procedure, but they will also let you go outside the military realm and use a civilian doctor. Here in Washington, the waiting period with a military hospital is a year and a half out. I didnt want to wait that long and my Primary Doctor agreed, she sent in a referral to TriCare that allowed me to use an "outside" doctor. Ive updated my profile with all the details if you need more information. Good luck to you!!
   — [Deactivated Member]

April 19, 2003
Hmmmm....okay, maybe I'm having one of my typical "blonde" moments, but I just peeked at your profile and it appears you've already had the weight loss surgery. Soooooooooooo, um, maybe it's not the WLS "procedure" that you're asking about?!?
   — [Deactivated Member]

April 19, 2003
Yes the do cover it. I am having surgery on May 19th and we have Tricare Prime. They approved me in 24 hours! I assume that is what you are asking if they cover but I do know that they also cover panniculectomies if you are having rashes and problems.
   — Tami H.

April 20, 2003
I am pretty sure Tri-Care Prime covers the surgery.. I had Tri-Care Standard... but did not need to worry about it bcaause my surgery was done 6 months ago in a military hospital. The wait was about a year but during that time I had all my testting done.. I was treated very very well by the physicains & staff . Spent a week in the hospital but that is standard for where my surgery was done. It's been 6 months and my weight loss is 90 pounds.. The only problem I am having is that my boobs seem to have fallen down past my waist.. Hopefully at some point I will be abl to gt thm reduced & lifted.. LOL.. Anyway, best of luck to you on your journey.. Follow your doctors instructions as best you can & take care..
   — Anne T.

April 24, 2003
This is the Tri-Care Handbook on-line. http://www.wpsic.com/tricare/handbook/part9.html It explains the rules for "Obesity Treatment". It helps to be well informed.
   — Kimberly V.

April 24, 2003
Yes definately a covered benefit for WLS. I work for tricare contractor and many of these are covered. Panullectomy is another story. Very difficult to get approved. Best off seeing if plastic surgery will do w/in MTF unless you have very good documentation from MD documenting wih pictures etc it is medical and not cosmetic. Also get nutrition consult w/in MTF this is not a covered benefit outside. Good Luck to all.
   — Jeffery K.

April 24, 2003
Yes. Tricare covers WLS if you meet the criteria listed in the handbook. They will also cover the panni removal, you just have to fight for it. I had one covered with no rashes involved.
   — Virginia N.