Question:
Has anyone been turned down by the Tricare docs.

I know when and if I have this surgury I will finaly be winning the battle of obesity. I guess I am a fraid of the Tricare doctors turning me down and I was just woundering if anyone has been turned down and what was the next step to make sure you got the surgery.    — tmalotte (posted on August 23, 2005)

August 23, 2005
Hi Tiffany, Well I am TriCare Prime, and I have been approved twice with no problem, the only requirement when I was approved was to be 100 pounds overweight, but if you have any other medical problems that are worse or might be cured due to weight loss it sometimes helps, like swollen leg/ankles, trouble walking, breathing, back pain, acid reflux, diabetic, things like that....I had a Lap RNY 4/13/05, I down almost 80 pounds, I feel great, and am ain't looking to bad either...so any other questions feel free to contact me okay....good luck....
   — dolpinette

August 23, 2005
I also have TriCare and had absolutely no problem getting approved. If you are 100# or more overweight with 2 co-morbidities (high blood pressure, arthritis, diabetes, back problems, etc ) that are documented by your PCP you should have no problems getting approved. When I had my surgery I only had to get the referral and then the surgeon's ok. Now, it is my understanding that you also need 6 months of documented weight loss attempt with a nutritionist or your PCP. This also seems to vary with region, so call your TriCare office and ask what the requirements are. If they don't give you an answer, have your PCP do it. You shouldn't have a problem. Good Luck! Carmen
   — kccjer

August 24, 2005
Tiffany, I just had surgery on the 6th of June (have lost 57 pounds so far) and had no problem with Tricare. I am Tricare Prime! I think they say you need to have at least two co-morbities and have to be 100 pounds overweight. But even then if your not 100 pounds over but your BMI is over 35 you still may be able to get approved for the surgery. I know of a few women who are also Tricare Prime and were able to get approved even though they weren't 100 pounds over. I don't think you will have a problem with it and if you do you will be able to find out what the next step is. Good luck
   — PreciousGemz33

August 24, 2005
Tiffany i just got my approval letter from Tricare and i'm on Tricare Prime Remote. the didn't batt an eye at the forms and approved me for surgery in less than a week.
   — Tera P.

August 25, 2005
Tricare itself isn't the problem to worry about, your Primary Dr is...took me 2 months to get her to do the referral but Tricare approved me right away
   — Ravenwulf

August 26, 2005
I have never really heard of Tricare denying anyone nor have I heard of them making it a long process. It all depends on your Primary doctor., and then didnt really ask for any proof of previous diets, etc from me
   — alina M.

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