Question:
looking for tricare sierra region one people

i am going through such a difficult time with this region. i have them on the policy of being 200% of ideal body weight but now they are telling me that i dont qualify using there weight charts. i told them i used metlife they wouldnt tell me who they used. i am 5.5 small/medium frame and weigh 278lbs. anyone go through this without any comorbs and still get approved. all answers greatly appreciated.    — tacy T. (posted on August 6, 2003)

August 6, 2003
I talked to one of the Tricare guys in my region today and he told me that in their office they use New York something...I know that's not a whole lot of help, but I know that New York was in the name of the chart they use to determine 200% of the ideal weight. I am not sure why your region is being so difficult. I'm not having any problems on that aspect, I am 200% of my ideal weight at 5'8, 285 lbs on a medium frame. You're shorter and weigh a little less, but not a whole lot and you also have a smaller frame. There should be no issue. I believe my region looks at the mid-range of the ideal weight for my height/frame and doubles that...maybe your region is looking at the HEAVIEST weight acceptable for your height/frame and doubling it. If that's what they're doing, I'm under the impression that they are SUPPOSED to use the mid-weight. In any event, they should have NO QUALMS telling you the chart they use, as you are entitled to do your own research. If what they're telling you is correct, then they should invite you to "see for yourself", you know? I think they're just mad that you got them on their own policy! I would ask to speak to some one higher up on the totem pole, or perhaps go down to your base Tricare office...and if all else fails, call a different region and tell them what your region is putting you through. Maybe they know some one that can help. Finally, I'll call my Tricare guy, Dan, tomorrow and get the exact name of the chart my region uses. I believe all Tricare offices use the same chart. I'll let you know. By all means, girl, keep your head up. You are entitled to this surgery based on their requirements. Best of luck to you and I'll email you tomorrow and let you know the name of that chart.
   — jenn_jenn