Tricare Approved! Waiting for surgery date!

Hello All,

I've been lurking for awhile.  I'm not SkinnyHusband, I'm his wife, Michelle.  He reads the forum but he's not a poster.  I've been reading and visiting to see what we are gonna be going through.  I don't see a lot of spouses posting, but I consider this a family thing because I think it is going to affect the whole family.  

We've been going through all the steps required by the surgeon and Tricare and received a notice last Friady from Tricare that said they didn't approve him for surgery (even though he more than qualifies).  What a loooooonnnnggg weekend waiting for Monday so we could call them and find out why.

Well, we have good news today!  Karen from TriWest called and told him she was on vacation last week and someone else had messed up and said he didn't meet the requirements.  I guess she is the POC for WLS at Triwest.  She apologized to him and said he was good to go!  

He should have a surgery date soon.  I will keep you all posted on his progress.

I enjoy reading about all your successes. 

Michelle
(SkinnyHusband's Wife)

Congrats and best luck to your husband,  I'm waiting for a Tricare approval to come through.  It's under review at the minute.  I meet the requirements but am a bit nervous about one.  I don't know if TriWest is different, but Tricare Prime require a 6 month physican approved/supervised attempt as part of the approval requirements.

The Doc's papers says weigh****chers would work so I submitted that.  It was over 9 months but I had to go out of country for a month in the middle of it all.  I'm hoping they don't get picky and deny me for not going for a month in the middle.

Does TriWest have that requirement?

 The 6 month physican approved/supervised diet is not a Tricare Prime requirement.  Tricare only has BMI/Co-morbidities requirement.  You can verify this on the Tricare website.  I think it may have been your doctor requiring the 6mo plan.  

Link to Tricare requirements:

http://www.tricare.mil/mybenefit/jsp/Medical/IsItCovered.do?kw=Gastric+Bypass
 
 

That is good news.  I wondered about that because I couldn't find that requirement on the website but couldn't get a straight answer out of them when I called.  The doctor seemed ok with the ww for me anyway, but definately gave me the impression it was coming from tricare.

We're in the West region...TriWest.  You are right HogRider, it's only BMI/co-mobidities.    When I was searching for it on their website, I just typed in "Gastric Bypass" and found what I was looking for.

Hopefully we hear in the next few days when his surgery is scheduled.

Michelle

As a Tricare (South) patient, I was able to get my approval and surgery. It only took me 18 months.....
It was a long bumpy road. But in the end has been well worth the effort. I am so far happy with my results alothough we all go thru "buyers remorse"
Ask away on here the Vets are wonderful sources of info!! And always remember this Walk SIP Walk SIP Walk SIP..... make it your mantra!!!!

IF either of you have questions ask away!!

I think the biggest challenge will be to not drink during meals.  Was that hard for you?  I always swig away while eating and I think it's going to be weird to break that habit.

 Congrats on your approval!
I hope everything turns out GREAT!  :)