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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 01-07-2008, 11:09 AM   #1 (permalink)
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Default Tricare and Plastics

I know there are other Tricare threads.. but I haven't seen anything specifically related to plastics and the possibility of having Tricare approve them, so here goes..

I know the Tricare handbook does not list plastics as an approved condition to GBS, and rumors are varied depending on base and surgeon as to whether or not they are actually approved when tried.

Has anybody here with Tricare actually tried to have plastics approved after GBS? And has anybody actually had any success with this??
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Old 01-07-2008, 11:15 AM   #2 (permalink)
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I'm interested to know and I will need them badly!
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Old 01-07-2008, 11:46 AM   #3 (permalink)
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I am tricare prime and this is just my experience so far .. while I was in San Diego ( where I had my surgery) they said if it was medically needed because of the extra skin ) rashes and such they would approve it without a cost and if your girls were really bad you could pay a few hundred dollars and have it done . They do body lifts, tummy tucks and such but for a few thousand , still much better than going out in town . So with all that said I just moved to Virginia Beach and was looking forward to getting a life this summer and maybe my girls back in place to find out they will not approve it here in Virginia and the wait list to even have the surgery ( Gastric bypass ) could be up to a year where as in San Diego it was about 3 weeks to a month wait if even that . So what I am assuming is that it all depends on your location.
If anyone has any additional info please let me know .. Hope this helps .. Like I said this is just my exp only .
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Old 01-08-2008, 08:14 AM   #4 (permalink)
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Some say they do some say they don't 5 out of 7 that I have persoanlly talked to said they do and have had it done tummy tuck breast lift and lifts in other areas. I was told by the nutrionist at the post hospital that they will do it as well. I think it really ends up in how it is submitted for the referal to get it done and also the region. As anyone who has dealt with Tricare knows that you never get the same answer twice.
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Old 01-08-2008, 09:53 AM   #5 (permalink)
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Quote:
Originally Posted by jtroth View Post
As anyone who has dealt with Tricare knows that you never get the same answer twice.

Boy isnt that the truth .. You Can call them 3 days in a row and get 3 different answers
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Old 01-08-2008, 10:18 AM   #6 (permalink)
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Default tricare

I have had GBS, then 14 months later I had a TT and next month I am having a breast lift. Now I had my breast approved for a reduction before I had the GBS, but I just put it on hold until I stabalized on the weight there was no time limit after the approval. As far as the surgeon goes both surgerys cost the same lift or reduction so they just state it however they need to, to get there money. If you know what I mean. Now I am overseas so the health care is payed for 100% so no deductable, which I know that back in the states you will be required to pay a percentage. With that you just need to find a good doctor all you need is a referral then usually the surgeons know how to get the approvals. Good luck
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Old 01-08-2008, 01:28 PM   #7 (permalink)
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My doc told me he would get my TT approved with Tri-Care and not to worry about it. I have Tri-Care Standard and after my GBS, we're only out of pocket for the entire thing about $1000!! I've spent alot more than that on diets over the years!

Tri-Care has been great so far!

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Old 01-19-2008, 08:29 PM   #8 (permalink)
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tricare south is beginning to require pictures. the skin will have to fall past the level of your pubic bone to be approved for the tummy tuck
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Old 02-15-2008, 12:00 PM   #9 (permalink)
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Hi!
I had my surgery here in SD and am starting to think about some nipping and tucking now that I'm getting nearer goal. could you be more specific about how you learned what Tricare will and won't pay for? I'd appreciate it!
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Old 02-15-2008, 12:21 PM   #10 (permalink)
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I had a pannis pre-surgery and already had a documented history of rashes.

I was told that Tricare Prime would do the TT but as I'm under Madigan (Army Hospital), I'll be a little more cautious cause they're not plastic surgeons!

I'm Tricare Prime.
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