I am looking for advice and support

Kelly George
on 10/1/06 9:14 am - Gresham, OR
Hi my name is Kelly and I am starting the WLS journey. I have been trying to get the surgery thru my husband civilian job but to no avail. I just got on the Tricare thru our reserve statis and wanted to ask you guys how hard it is to get approved thru the military? We are paying 100% of our premiums a 300.00 jump from our other insurance so I am praying it works. My Husband is a Air force boom operater here in portland oregon and we just got BRACKED so we really dont know what is next. he's just got 2 years of good time to do before he can retire. It breaks my heart becouse he loves refueling and I know that its proubly over for him as he cant find anyone that will take him due to his age and our inability to move. I am almost 43 years old and weigh about 300 lbs. I have been overwieight most all of my adult life and the one time I really lost weight it was in my early 20's and it was mostly in part to a drug I was using and so I dont feel that it really counts. I am a very active person I swore that I would not ever let my weight stop me from living life. WEll time marches on and so dose the age and effects it has had on my body and I just cant hack it anymore. I am sitting on the side lines and I just dont want to be there any more, I know I am just a few years of being diabetic as my mother is and my sister. So I am ready to do this. If the tricare for some reason wont cover I will do it on self pay although I would hate to do that to my familys finances. Anyway I was hopping for some help from you all advice? suggestions? how to get covered thru the Tricare? I look forward to your responses and maybe finding the support I know I need right now Kelly
APRIL D.
on 10/24/06 6:15 am - Anchorage, AK
I know that Tricare does cover the RNY and that's the only one right now.. Their only requirement is that you have a BMI over 40 or are 100lbs overweight. I'm not going through a civilian PCP so I'm not totally sure how that works, but I'm sure it's not much different from the military PCP.. Here is some posts that people in Oregon made about Tricare.. Just scroll down till you find TRICARE. There is one that says Tricare Remote.. Ignore that and keep going... Hopefully this will help you out. http://www.obesityhelp.com/morbidobesity/members/list-insurers.php?State=OR&alphaPos=T April*
cfkap8
on 11/1/06 9:27 am - MD
Hi, Kelly. I haven't been on this site in quite a while. I know that you had one response but I thought I'd stop by, say hello, offer support and see where you are in your journey. A little big of info; Tricare does cover only the Gastric Bypass at this time and the other person is correct on the BMI and the 100 pounds. However, there is also another requirement of a comorbidity, high blood pressure, diabetes, etc. I was approved for surgery, after being referred by the PCM, in minimal time. I think that I went to the surgical appointment, did their testing in the office for a few things, filled out paperwork, had my eval with the psychologist and was then approved in like two days. They readily do this surgery. Unlike other insurance companies who hee haw around for months, make you do this and do that, Tricare is quick. I had surgery 10 months ago on January 23. I have had a wonderful experience, no complications, quick and easy recovery, easy time adapting to my new lifestyle, and have truly enjoyed this amazing, wonderful journey. And it is a journey with ups and downs. But if you're in the right frame of mind and this is truly in your heart, it's good for you. I started at 282.5 and right now am 178. I have about 10 more pounds and I done. However, if I don't lose another pound, I'm fine with that. I can handle 178 pounds. I wore a size 26W top, 26W pants and now wear a L top and a 12 pant. Life is great! I don't believe in talking anyone into surgery, to each his own decision. But for me, it's been a great decision. I am happy to talk with you. Email me anytime with any questions you may have. I will answer them to the best of my ability and won't mislead you. Be careful, there are some folks who will do just that. My husband and I are stationed in Montgomery, AL. He is active duty, 24 years. I look forward to hearing from you. K. Perkins
Maria Finan
on 1/3/07 11:10 am - Richland, WA
Kelly ~ It seems as though you've already received some great information. The only thing I say different is that I have a friend who met the 100 pounds over ideal body weight and had no comorbidity and was still approved for insurance 1st time out. Maybe the different Tricare regions have slightly different rules (we're TriWest up here in Alaska). I'm about 18 months out and have never regretted this surgery a single time. I'm one of the lucky ones who has never mourned the loss of food. I'm 5'8" and started out at 272 (although my heaviest was probably around 290 in 1996). My first goal was 170. I hit that within the first 6 months and revised my goal to 155. For the past couple of days, I've been teetering between 142 and 144 and can hardly believe how far I've come. My husband and mom keep telling me not to lose any more; but I'm not actively trying - it just creeps off. I've gone from a size 22/24 to a size 6/8, 2x/3x to a s/m. It's been an incredible journey. Although I've not followed all of the rules to the letter, I've been pretty vigilant with most of them. I'm adamant about getting in the vitamins and supplements but often lax about getting in enough protein. I drink coffee (lattes and breves because mochas are just too "heavy" in my stomach). I do eat carbs but am more inclined to eat good carbs - whole grains, fruits, etc. My exercise has been off and on - right now it's off due to a bad bout of rotator cuff tendonitis. The real first step is to go to your PCM/PCP and ask, "Am I a candidate for gastric bypass?" If he/she says yes, ask them to put in a referral to Tricare. That should get the ball rolling. Best of luck, Maria 272/155/143
kandy62
on 8/2/07 5:46 am - Seymour Johnson AFB, NC
I spoke with someone from Tricare yesterday. They do not require the BMI anymore. They still use the 100 pounds over your ideal body weight. A good place to go get information is www.mytricare.com You can ask a question and someone will replay back to you in about a day. You can also check the status of a claim or referral. I use that because I had a referral go through but did not receive a letter. My referral had been approved for about 2 weeks before I knew about it. Good luck. I am going through the same thing. I went to my WLS Educational Class this morning. It went great. I will get my appointments for labwork, psy. consult, nutrition consult, ultrasound and endsocopy next week.
Most Active
Recent Topics
Married during AIT?
airberg2b · 0 replies · 589 views
little rock AFB PCM
elromine · 1 replies · 368 views
hi
RJOLLY1967 · 2 replies · 392 views
×