Question:
for military, how to go the surgery?
we live at fort wainwright, and i am not sure if there is a doctor here that does this surgery..if any one knows please let me know? for those that have had the surgery.. did you go to your PCP first? how was it dealing with tricare? how about having to travel to get the surgery.. were you able to get tdy? the cost of having to travel is a big reason that i am putting this off. we dont have the extra money for all of the travel that would be involved. if any one can tell me how they did it, with tracare and having to travel please let me know — Rebecca73 (posted on September 30, 2004)
September 30, 2004
Hello there,
We are retired from the Marines. I was referred out to a civilian center.
It cost me very little. I understand the distance and money. i am certain
that there will be someone at the base near the doctor that you are
referred to that can help you with a place to stay. Also remember, that the
expenses are tax deductable. Best of luck to you.
Loriann
— Loriann J.
September 30, 2004
Yes, you go to your PCP first to ask for a referral. They are more likely
to take you seriously and get it done for you if you go in armed with
information so they know you've researched it. If you meet the requirements
(BMI of 35-40 with obesity-related health issues or 40 with or without)
they SHOULD put you in a referral. There are some WLS-ignorant doctors out
there though. Don't let them talk you into a corner, and let them know that
YOU know you're eligible.
When they put in the referral, they should be able let you know if it is
even done near you. If not, you'll have to talk to a Tricare
representative. If it's found that they can't do you at Fort Wainwright,
they'll look for another nearby military hospital. If there isn't one
within a certain distance (I want to say 100 or 150 miles?) that does it,
they will refer you to an "in network" civilian surgeon. So I
wouldn't worry too much about travel. At worst, you might end up with a few
day-trips, I would imagine. :)
A friend of mine had to go about this that same way. She had to travel to a
(civilian) doctor nearly 100 miles away for hers. Fortunately that doctor
allowed her to do her pre-op tests in her local area, having the results
sent in to him, as well as allowing her to attend her (required) support
group meeting local to her area. She only had to make I believe 3 trips up
there prior to her surgery. For initial seminar, one-on-one consult, and
final pre-op visit. Everything else was done on or around the base she
lived at.
If you do end up being able to go to a civilian surgeon like that, remember
the "in network" part is important. Tricare reps can give you a
list of "in network" providers, or else you can just search for
bariatric surgeons yourself and ask if they are "in network." It
is NOT the same as just "accepting Tricare." Being "in
network" means they will only charge what Tricare allows-not leave you
with the remainder, which could be tens of thousands of dollars!
At first, I was told I had to have my surgery at our local miltiary
hospital. But then they lost both their docs and I was referred to the
network. I ended up having my 30,000 dollar+ surgery almost entirely paid
for. I paid for maybe $200 worth of things not covered but required by my
surgeon! And that denial was only because I had had them done previously
when I was supposed to have gotten in at the military hospital-my doctor
wanted more updated data.
— christied
October 1, 2004
I am in Maine, and am on Tricare while my husband is deployed with the
National Guard. I am working with an "in network" surgeon that
is an hour away. There was one closer to me, but he had a two year waiting
list. Since I have limited coverage time, the refferal department with my
PCP worked with me to be able to go to the surgen with the shortest waiting
list. I've been fighting a little bit to get a few things covered, but
since the person in the refferal department is willing to fight for
coverage with me, it's been fairly easy. Just make sure that your refferal
department and Tricare representative are on the same page about what is
covered and what isn't. So far I haven't had to pay for anything, but I'm
still in the early part of testing and stuff.
If you have any questions, feel free to e-mail me.
— mrstank
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