Extra! Extra! NEW TriCare Policy Adds Weight Loss Options

This is great news from TriCare.  My original surgery was October 20, 2003, and by October 2004, (paid entirely by TriCare) I lost 165 pounds and TriCare quit having ANYTHING to do with Lap Band.  Of course this is when my slippage problems started and I’ve been living with a band that doesn’t work and regained 100 pounds.  I’ve been in the process of having my wonderful surgeon going to replace my band anyway, and now hopefully this will help, even though he’s not on my approved list, at least he’ll get more than if he was not.  I hope this is helpful for some people, I know that TriCare has left many in the lurch.

New TRICARE Policy Adds Weight-Loss Options (Article 2)

(from the March 4, 2008 newsletter

A recent change in TRICARE policy now provides coverage for laparoscopic adjustable gastric banding (Lap-Band® surgery), opening new avenues of treatment for those fighting morbid obesity. This policy change is retroactive to Feb. 1, 2007. If you’ve had Lap-Band surgery since Feb. 1, 2007, and qualify under the new policy guidelines outlined below, you may submit a claim for reimbursement or, if you submitted a claim and it was denied, you may appeal the denial.

Lap-Band surgery is a minimally invasive procedure that can help you shed excess body weight. The Lap-Band shrinks your stomach and restricts how much food you can eat at one time.

You are eligible for Lap-Band surgery if you meet any one of the following conditions:  

1.  You are 100 pounds over the ideal weight for height and bone structure and have one of these associated medical conditions:

• Diabetes mellitus

   

• Hypertension

   

• Cholecystitis

   

• Narcolepsy

   

• Pickwickian syndrome (or other severe respiratory disease)

   

• Hypothalamic disorder

   

• Severe arthritis of the weight-bearing joints

   

2.  You are 200 percent or more of the ideal weight for height and bone structure. An associated medical condition is not required for this category.

3.  You have had an intestinal bypass or other surgery for obesity and, because of complications, require a second surgery (a takedown

For more information about Lap-Band surgery, talk to your doctor about the benefits and risks of the procedure.