Has anyone had the sleeve with approval from Tricare Prime?  I'm on the west coast and we have Tricare Prime (United Healthcare? I know they have something to do with it).  I saw that the sleeve was covered and then a few days ago they updated the "What do we cover" page and now the sleeve is not listed.  Has anyone had it covered?  Am I completely out of luck now?  I feel lost!

From TRICARE.mil:

Bariatric Surgery

TRICARE covers the following open or laparoscopic bariatric surgical procedures:

• Roux-en-Y gastric bypass
• Vertical banded gastroplasty
• Gastroplasty (stomach stapling)
• Adjustable gastric banding (i.e., adjustable LAP-BAND®)

All of the following conditions must be met to qualify:

• You're at least 18 years old or you must provide documentation of completion of bone growth.
• You were unsuccessful with non-surgical medical treatments for obesity. Your medical records must show your failed attempts.
  • Diet programs, such as Weigh****chers^®* and Jenny Craig*, are acceptable methods of dietary management, as long as there are monthly clinical visits with your doctor and medical documentation of your participation and your progress throughout the course of the dietary program. *These programs are not covered by TRICARE.
  • Physician-supervised programs made-up of only weight-loss medication management, do not meet this requirement.
• You have proof of one of the following:
  • A body-mass index greater than or equal to 40 kilograms per meter squared (kg/m2); or
  • A body-mass index of 35-39.9 kg/m2 with one clinically significant comorbidity, including but not limited to, cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnea, Pickwickian syndrome, hypertension, coronary artery disease, obesity-related cardiomyopathy, or pulmonary hypertension.

TRICARE doesn't cover the following services:

• Office visits solely for the treatment of obesity
• Non-surgical procedures for treatment of obesity
• Nutrition and diet counseling
• Biliopancreatic bypass (jejunoileal bypass, Scopinaro procedure)
• Gastric bubble or balloon
• Sleeve gastrectomy
• Gastric wrapping/open gastric banding
• Unlisted procedures

If you want to have the sleeve, you will have to go to a military treatment facility in your area. United Healthcare is the regional administrator for TRICARE in the west region; it is responsible for issuing payment, processing authorizations, assigning primary care managers, etc.

Good Luck