Tricare coverage for VSG

I have been trying to get Triwest to approve the RNY through a civilian surgeon but I am having issues even though I qualify. I am debating on asking my PCM for a referral to Balboa because I think it is the closest MTF that performs the procedure. I live in Pt Mugu which is north if LA. I am curious of what the process is for WLS there and how easy it is to get them to do it? Any info is much appreciated!

Just this week I called TRICARE about the sleeve.  I am on TRICARE PRIME, but TRICARE is TRICARE.  THEY DO NOT COVER the sleeve at this point in time.  The person I talked with looked not only at the current manual for me but also all the memo's and new admin notes. 

If you have access you can use a Military Treatment Facility, if they perform the surgery.  You will need to call the MTF directly and speak to the general surgery center.  I have my first appoinment with them next week.  After looking at the good / bad of both the Band and the Sleeve, to me the sleeve wins hands down.  Good luck!

The Bariatric Center in the DC area (two hospitals, one program) does the VSG - and they ONLY take Tricare Prime.  If you look on the Insurance board, you'll find others who have had the VSG covered by Tricare - I've seen both Standard (rare) and Prime.

Wouldn't it be nice to have a list of all military and VA hospitals that do WLS??  Along with what they take?? Some VA hospitals do it - I've corresponded with a retiree who had a VSG done recently. 

Sheri

Sheri,  Do you know the names of the program and hospitals?  I am in PA, but willing to travel!  Thanks so much!  

   How is this true.? I have TRI CARE PRIME WEST 

My surgery was July 20 of 09 and I was a first time wls patient and they covered my VSG from the start. 

 I have 3 other friends on this board who have also had this surgery...  2 of them had their surgery as early as 6 months before me and the other one was just 2 weeks ago.

 I had my surgery at Balboa Regional Military Treatment Facility which is located in San Diego

 I also have a friend who is seeing a surgeon on Feb 9 of 2010 at scripps also in san deigo and he does the VSG  for tri-care patients.

 Another friend of mine who is an air force wife who is seen @ walter reed and they approved her for the surgery but pushed her out in town due to the volume of patients. 


So am i misunderstand that people are being told they can't have the surgery period  ( as in the VSG ) or just not with a CIVILIAN FACILITY  .... 


????

the statement I posted came directly from my Tri care rep. She called headquarters in DC to clarify/

Military Treatment Facility's are not under Tri Care. Unfortunatley the MTF near me does not perform any WLS.

It looks as if those of you who had the VSG with TriCare went through an MTF, which essentially is not Tri Care.

Is there anyone out there who's had the VSG with Tri Crae (not at a military facilty) I would love to know the insurance code you used!

I have chosen to go through with the RNY but would change to the VSG if it was covered.

   

 I will keep you updated cause like I said I have a friend who is being seen by a civilan doc and she is in the process.

Ditto Chica... So i can figure it out and give the info to Dr Owens.

Thank you all for your help!  Do any of you have the names of the hospitals in the North Region that performs VGS?  Thank, again.  I appreciate all of the imput!