Tricare + new diet guidelines

I have a failed lapband and need revision.  Today I was told Tricare needed 6 months of supervised weight loss by a physician.  I've been filled, unfilled, refilled, unfilled, etc. and am now unfilled and miserable....waiting to get ridof this band.  I can understand this for someone that hasn't already had surgery, but I was moving right along until my lapband failed (went up into my diaphram-now unfilled and back where it's supposed to be).  This last year has been miserable and I've followed my Dr's ordered to a tee and now this......FRUSTRATED.  Thanks for letting me vent!!!

Hi,
I am sorry to hear that you are having such a hard time.  If you have been under your doctors care with all these problems then you should have no trouble at all with his office supplying the required documentation.

I have used Tricare for the last 25 years.  I now have Tricare Prime as my secondary insurance. Every time a problem arises I have called and they have been pretty fantastic on getting the problem handled. 

I suggest  that you call Tricare tomorrow, explain your situation and  ask them what you need to do, to get the ball rolling on getting the help you need  to have a better quality of life.   No one should have to live in pain.

Best of luck.

I'm sorry you're going through this. It's not uncommon... a LOT of us had bands that failed or damaged us.

It seems that your doctor should be able to "vouch" for the supervised weight loss. You might need to explain in detail to the insurance company... have your medical records near for reference. OR perhaps someone at your doc's office is able to explain it, if you're more comfortable with that.

GOOD LUCK. Having the band removed was like being able to start living again. It's a horrible device.

 

What region are you in?  I heard someone from the north (Healthnet) express that on here a few weeks ago.  Based on the Tricare guidelines, it shouldn't change.  I know Madigan does revisions, are you wanting to see a civilian?  If not, you can ask to come this way to do it.  We had a lady in group a few months ago that flew out from Carson to have her revision, band removed, and esophagus fixed.

As other posters have said, you are supervised now, I would request the past 6 months with your provider be submitted as the supervision.  You can always appeal the decision as well.

 hi whit
i have tricare also and my clinic told me i needed a 6 month dr visit. upon talking
to tricare, they told me that they do not have a 6 month policy. i would ask them again
and show you on their website where it is listed (as it is not there) on tricare.com

can i ask why your band failed?

I was overfilled and the Dr in FL says I wasn't. It made me really sick for 7 months.