Just so you know if you're going to an MTF it didn't go through Tricare. . .  Basically being seen at an MTF means you follow their rules not tricares.  But great job being approved through the MTF.  I am to at Bethesda.

Well Folks, I have a date of 10/3/11 to get sleeved, unfortunately I have been denied not once but twice already..the first being from the original submission the 2nd my surgeon and a MVP medical doctor case conferenced and it was still denied..soo now I have to appeal!  and I need any advice on this that is available!!! ....My doctors ofice is telling me to keep all my pre-op appointments etc but I dont really want to waste all that money paying for co-pays if Im not gonna be able to have my surgery, very frustrating...another thing is m doctors office is telling me to chose another surgery, personally Its not that easy for me, I have my mind set and have researched on a particular procedure so for me to be told to do the rny or the band..umm no!..lol..sorry to vent! but please help!! 

Tricare actually has new rules now. It isnt on the tricare websites, but it is in the tricare policy manual as of 8/17. The policy is supposed to be on the tricare sites in a week or so from now but it is actually on the Tricare Management Activity website under the tricare policy manual. It is based on the 35-39 bmi w comorbidities and 40 and over without any comorbidities needed.

http://manuals.tricare.osd.mil/DisplayManualPdfFile/TP02/145/AsOf/TP02/C4S13_2.PDF


I believe this is the page that can give you the new information.

My BMI was right at 40 with no comorbidities and I was approved with no problems. (I have Tricare Prime and am getting the sleeve at an MTF.) As it turned out, the sleep study determined that I have severe sleep apnea (I was shocked...I didn't think I had any sleep issues at all) so now I do have one.

GL!

Im going through the same thing right now.. I have UHC and im currently trying to get the sleeve done and for the past 5 years my BMI has averaged about 36 to 39 and im nervous they are going to deny me, idk if they are really strict or if they go case by case but im talking to a case manager Sep 12th so i'll see,, Good luck i hope you get it!