Question:
How likely is it that Tricare will approve gastric bypass?

My insurance provider is Tricare. My husband and I are in the military stationed in TX. I am considering gastric bypass and I am worndering what steps I should take to be approved by my insurance. Currently I have the referal from my PCM and have underwent a psych evaluation. What should I do I help get approved?    — [Deactivated Member] (posted on July 31, 2003)

July 31, 2003
Yes, Tricare will absolutely pay for your weight loss surgery. I'm 4 months post op and Tricare has paid for everything. I paid roughly $25 for my portion of the hospital bill and that's it. My PCM wrote to Tricare recommending that I have the surgery. Tricare sent him the name of a surgeon that they authorized me to see. The surgeon's office dealth with Tricare from that point on and I was out of the loop. Easy as pie! Feel free to email if you have any further questions. Best of luck!
   — Vicki S.

July 31, 2003

   — franbvan

July 31, 2003
Each govt contractor may be different, but all follow the same guidelines, per policy, that another patient just posted. I think that TRICARE has one of the best policies for covering this procedure (and not just because I work for them!)
   — richarro

July 31, 2003
Hi Emily, Tricare is wonderful like all the other post have said, my approval process took all of about a week to get, THAT'S IT !! I see alot of people waiting 3 and 4 months.. if you want more opinions on TRICARE, go up to the "insurers" link on the top of any page, and you can look up different listing people have put about tricare,,i am in ohio, and i believe i go to page 22 and that starts with tricare,, GOOD LUCK !! Kelly, P.s if you need anymore help just email.. ;o)
   — kelkel319

August 1, 2003
I guess I have to always be the bearer of this information. Everyone's case is different and you may have a hard time with Tricare. Do not let yourself get set up on it happening as fast as others and on not getting denied. See my profile and you will see why. I got denied after waiting 6 weeks for approval. This may have been a fluke but I had read how everyone got approved in 2 days at the most 2 weeks and some who didn't exactly fit into Tricare's policy for approval and I was very disappionted when I was denied.I did appeal and I just had my surgery two weeks ago I had been actively working on getting this done since November. I wish you luck in getting through this with your sanity. Luckily most of mine is still intact.
   — S C.

August 2, 2003
I am a military retiree wife. I have TricarePrime. I went to my family practice Dr and told him I wanted surgery. I have type 2 Diabetes, high blood pressure, high chol. He agreed and put the papers in for the approval. In two days I got my approval. I live in Pensacola Fla. I had my surgery done July10 2003. I am 4 weeks out and have lost 40 pounds. The only thing Tricare didn't pay for me was the psych evalation. I put a a claim for that $300. Whis you all the luck and the surgery will give you a new life, I know I am 60 and feel like a new person. Karen Stewart
   — Karen S.

August 2, 2003
Hi, I had my wls paid for by Champus Tricare. They will pay for the wls, but they won't pay for any other type of weight lose. Like pills, a therpy, or the like. So you will be ok, and GOOD LUCK with your new future. Sharon Langford
   — Sharon L.

August 4, 2003
I also have tri-care prime and I am also in Texas. I had no problem with them, they have been great!! Once my surgeon submitted the info it only took a couple of days for the approval. Good Luck!!
   — kindred S.

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