Does anyone out there have Tricare Prime? Do they cover Lap band?

I am new to this and I have lots of questions. I do not have an appointment for the WL seminar till April! I have Tricare Prime and am leaning towards lap band but will try something else if I have to. I am just scared of having bypass surgery. I will work on my profile later. The family is waiting for their dinner!

Tricare Standard has coverage for Lap Band. In the Hampton Roads area, Tricare Prime patients can only go to Portsmouth Naval for gastric bypass. Has your primary Dr. put in a referral for you? Good luck!

Well I have an appointment for one of the seminars in April. I was not aware I could go to Portsmouth Naval. I thought because we are retirees, we had to use a network doc. The doctor I would like to do the surgery has a practice, but he did do a friend on mines surgery at Portsmouth Naval. Her hubby is active duty though. I do not think I will have any problems getting what I need from my PCM. I just do not know if I could do the gastric bypass. My family would have a fit. My husband says he supports what ever choice I make. I would just feel better if I new ahead of time if Tricare would approve. Thanks!

I am Tricare Prime and we are retirees also. I had my surgery done at Portsmouth 6 months ago. Tricare covered all but the daily $16 a day in the hospital. I got magnificent care Dr. Chastanet and Dr. Mann are the most considerate and careful doctors I have ever had. You will have a wait but it is the best thing for you. They require 6months of supervised weight loss I did WW for a year prior to surgery and lost 27lbs. Take the waiting period to make all the lifestyle changes and you will have a really easy time and very successful weight loss. The only thing I didn't do prior to surgery was learn not to eat and drink at the same time waiting that 1/2 hour before and after meals to drink is a struggle for me.

Please go online and research Obesity Treatment on Tricares site........It will list all the approved means of Obesity treatment. The last I saw Tricare does not cover Lap Band at all - only gastric bypass, because they consider Lapband to be in experimnental stages without enough long term study. I have tricare standard - my husband is active duty, and have recently researched this in the past few months.....but they may have changed their terms. Good luck, I hope all works in your favor......I know Tricare is not always the easiest to work with!! Hugs! Terri

Tricare actually told me it can be covered, it just depends on the codes the doctor uses to bill. I get different info each time I call. I am so confused. I have just about given up on the Lap Band idea. So how come you are not going to PNH to have surgery? I have the seminar scheduled with a civillian doctor in April. I called them and they said they have done surgery on Tricare Prime patients. I just know I am asking everyone lots of questions. I already have my mind made up that I am going to have surgery. I just want to have all my duckies in a row when I see the surgeon. Thanks for the reply and any info you can share is really appreciated. Chrissy

Christina, I have Tricare prime also, but I never look into lab band. I got a referral from my dr. then made a app.. with Dr. Chastnet at PNH. I had RNY 6 months ago. Wish I could be more help. You might want to call the bariatrics clinic at PNH for some more info, they are very helpful.... if you want the # to the clinic then send me an e-mail at [email protected] Good luck, Minette

Thanks for the reply. The number would be great because I have a few questions. So did you choose to go to PNH or did Tricare send you there? I called Tricare and the lady told me that I did not have to go to PNH. I am scheduled for a seminar at Bon Secours Weight Loss Center through Tidewater Surgical. They are network providers. I am going to ask my PCM on friday for a referal to them and see what happens. I have kinda give up on the Lap Band idea. My husband says he supports whatever option I choose. I just know that no matter how long I have to wait, I am going to do it. Thanks again. Chrissy

I know when I looked into this I called TRICARE and they told me that they will only pay for the Gastric Bypass. The band is to experimental for them to pay for even thou its cheaper and has less complicatons. I have standard. My hubby has prime. When I asked them what the difference would be between the two they told me nothing because its a straight TRICARE policy.The prime is just a HMO you have to see there Drs. The standard allows you to see any Dr but you might have to pay more. Honey have you ever seen that lap band? Touched it and seen how big it was? I dont wanna freak you out but after seeing one and how they will make you go back to have that thing tightend all the time I myself prefer the Gastic end of things. Vickie

Hi Christina... Im Tricareprime, also. All I know is that there were alot of retirees in my orientation. One of my coworkers will be in the orientation in April, too. Not sure about the lap-band thing though. Good luck! Joy