going great so far!

Hey everybody, I just thought I'd pass along my most recent successes.  I met with my Diet Nazi , er, um.....  Psych Evaluator last week.  To my surprise, she wasn't the "Diet Nazi" she was when I first met her.  She was beaming with pride as I told her how well I've been doing with the changes I've made, the support I've found both here and at work, my food diary, my wight loss so far in preparation for eventual surgery, my physical therapy to help get me in shape for more regular exercise, etc.    Having finished my last visit with her, I let my surgeon's office know I was done with all my pre-op appointments and now I have a "decision appointment" scheduled with my surgeon in 3 weeks.  I don't know why they call it a decision appointment.  I wouldn't have gone this far if I didn't want to do this!!  My only concern now is waiting and fulfilling the requirements of my secondary insurance, which is Tricare Standard.  My primary insurance will cover 80%, but I really need my secondary insurance to pick up the majority of the rest.  I'm told that Tricare requires a lot more than my primary insurance.  I really hate to prolong my surgery for perhaps a whole YEAR jumping through more hoops just for that 20%.  **sigh**  Is there a way around this?  Suggestions anyone?

Maybe since TriCare isn't the primary insurance it won't be as bad. It's good to know that things are moving along so well for you. I don't understand why they call it a decision appointment either. Hmmm? 

Have a great Day!!!
- Iris

Hi,

Tricare was my primary insurance and I did not have any trouble getting approved.  The only thing that they required that I know was not required by most insurance was the H-Pylori blood test and a chest x-ray.  I can't imagine it being any different for them as secondary!!  It only took 2-3 days to get my approval in.  Good luck and stay on top of it.

That's reassuring!  It was my surgeon who told me that TriCare tends to require up to a year of waiting for things like a documented diet and weight loss plan.  I have been so fortunate so far to have both State Employees BCBS with TriCare as my secondary insurance so far.  I rarely pay a penny in medical costs, except for pharmacy costs.  And if I can get the right forms to send in to TriCare, I'll get some money back on those. 

I have Tricare Prime which is a bit different then yours but I didnt have to pay one penny and just had to do all the preop testing like normal. I hope you get fast results with them!!

Did it take long to get approved and did you have to go through a year of documented dieting under your primary care physican?  That's what I was told might happen.

I didnt have to do ANYTHING but the pre op testing, no liquid diets, no supervised diets no nothing!! once paperwork was in I was approved in four days

That is so great!!  I feel so much better.  I have been under the impression that I would have a year's worth of hoops to jump through.  Not seeing a light at the end of the tunnel has been frustrating and disheartening.  When you wanna do something, you wanna do it NOW, not a YEAR from now!!  As soon as I do my "decision appointment" in 3 weeks, I guess they're file and we'll see what happens!  I think I'll still call ahead and speak to someone at TriCare beforehand.  I don't want to rely solely on my surgeon's office to take care of things.

Hi Meredith,

I know that my husband was approved by his primary insurance and his secondary is a medicare replacement policy and we are in the same position needing to have them pick up as much of the 20 percent balance as possible. And like you, it is our secondary insurance that has stricter guidelines that need to be fulfilled. I would suggest that you contact Tricare Standard and find out exactly what they require and what the timeline looks like. One issue you may need to address is how long the primary's approval is good for ... Often, it's 90 days. If the secondary takes longer than 90 days to complete whatever they need done, the primary may need to re-certify. It's good to know who needs what and what the timeline looks like so that you can get everything sync'd.

Wishing you all the best,

Barb

Wow, I hadn't thought of that!!  I'm so glad you brought up the point about synching the insurance coverages.  I suppose it's entirely possible that my primary will approve, then the secondary sends me through months of hoops to jump through only to discover that I'll have to go through another set of hoops again to re-qualify for the primary!!  What a tremendous headache and heartache!!!  **sigh**  Now I've just gotta find the time to sit on the phone and wait for someone to talk to about it!!