Question:
WHAT ARE THE CHANCES OF GETTING DENIED WITH TRICARE PRIME
I HAVE TRICARE PRIM CURRENTLY IN FORT STEWART GA AND 235LBS 5'1 BMI ACCORDING T THE CHARTS 44.4 I DO NOT HAVE MUCH PROOF OF ME TRYING OTHER OPTION BUT I HAVE AND I AM CURRENTLY IN A NUTRION CLASS BUT ITS STILL NOT WORKING I HAVE MY VERY FIRST APPOINTMENT WITH THE SURGEON 6-24 PLEASE HELP WHAT ARE MY CHANCES OF GETTING APPROVED — JENNIFER S. (posted on June 12, 2003)
June 12, 2003
Your chances of getting approved depend greatly on your co-morbidities and
your diet history. My recommendation is to sit down and make a list of
every diet you've ever been on and when and what your weight loss was. If
you've ever been followed by a doctor because of your weight be sure to put
that on the list too. Also, make a list of every medication you take and
every "problem" you have that could even remotely be associated
with obesity. Joint pain, irregular periods, migranes, diabetes, GERD,
etc.... If you go into your visit armed with this info it will make it
easier for the surgeons office to do up a first letter that is more likely
to get approved. Also be sure to read the Tricare Handbook section on WLS
so you know exactly what the requirements are and when you're making up
those lists for the surgeon be sure to state how you meet all the
requirements! The link to the Tricare book online
http://www.tricare.osd.mil/TricareHandbook/
— Anne R.
June 12, 2003
— Anne R.
June 12, 2003
I am almost 9 months out. Tricare Prime approved me in one day, but I did
have a history of failed diets, high cholesterol and depression. The
biggest thing is that you are over 100 pounds over your ideal weight. Good
Luck!! Janelle Open RNY 09/17/02 - 282/159/145
— Janelle G.
June 12, 2003
I am at Ft. Polk and just had surgery by a civilian doc on May 19th. I was
approved for surgery in 24 hours and I did not have any documented weight
loss attempts although I have tried them all. So, with your BMI, I think
you will not have any problems at all. Good luck!
— Tami H.
June 12, 2003
I was shocked when I saw this I said I wouldn't post until I was approved
but I had to chime in on this one. You must check your ideal body weight
and make sure it si 200%(2x's the ideal) If you are then you won't have a
problem. Make sure your diet history is detailed, and any comorbidity that
TRicare recognizes is a plus. I was denied just yesterday by them for not
having enough diet attempts and not having any doctor supervised diets.
Good Luck but I don't think you will meed it your BMI is 44.4 and I am
guessing that means you meet the 200% requirement. I missed that by 13
pounds.
— S C.
June 12, 2003
I also have Tricare Prime and I was approved the same day with no
comorbids. My BMI was 43 and I did have a very detailed diet history. My
family history is also very sad with many obesity related issues. Good
luck to you.
— TraciB
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