applesosaucey

Ok im going to try to make a long story short....

I use to have Health Net, every doctor I saw agree that I needed surgical intervetion because my weight but stupid HealthNet wanted me to do a 6 month supervised diet which I was unable to afford. It was 400.00 a month times 6 equals 2400 dollors that I don't have because im married with a toddler.

Now my husband is Active Duty and I have Tricare standard According to Bariatric Surgery coordinator said if im 5'7 I need to weight and min of 294lbs to get it covered without co-morbities because that would be 200% of my disered weight for my height I weigh 296lbs. I whcih makes me happy because I already feel approved My ins told me they only cover 85% and I would be responseable for the other 15%

Any one had any experiance with Tricare Standard?

How much did you pay out of pocket?

What was your process?

Should I feel like im getting the surgery of am I jumping the gun?

Please let me know.....

Thanks

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.:Visit History & Process:.

01Oct2009 Appt with PCP who will refer me to the surgeon I chose .....

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http://tickers.TickerFactory.com/ezt...U91/weight.png

pbeck91

Is there a specific reason you chose tricare standard instead of prime? Prime has covered every bit of my surgery, they even 100% covered a home health nurse for 7 days to come check my vitals and give me a shot of lovenox every day! I can't complain about tricare prime one bit!

applesosaucey

I chose standard because I get to chose my sugeon. Plus it seems like the process is easier with standard (its like a PPO)

__________________
.:Visit History & Process:.

01Oct2009 Appt with PCP who will refer me to the surgeon I chose .....

........


http://tickers.TickerFactory.com/ezt...U91/weight.png

AirForceW1fe

I have Tri Care Prime as well. I was allowed to choose my surgeon. I did not want the co pays with Standard. I am not sure if there is any difference in the approval process. Mine was really fast, less than 60 days after I had been researching it for 8 months before I even made the decision to meet with a surgeon. I had 2 co morbities though at 5'7'' and 275lbs.

Yeah I can't complain about Prime either, $78k hospital bill, we paid $25. No way I could have afforded to do it any other way. I know when I was looking at Standard though the amount I would have had to pay out of pocket was minimal, I want to say under $1000 and the surgeon was willing to accept it in installments if we needed to.

Hope that helps, and good luck to you in your journey.

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Surgery Date- 7/14/09

Pre / Current / Goal

285 / 209 / 140


Scale aka "Satan" Whore #62

"No one said this would be easy, but boy is it worth it!!!"

applesosaucey

well I hope im right everyone ive spoken to makes it seem as if im already approved

__________________
.:Visit History & Process:.

01Oct2009 Appt with PCP who will refer me to the surgeon I chose .....

........


http://tickers.TickerFactory.com/ezt...U91/weight.png

Shetaz0028

I'm a Primer too and my total out of pocket expences for all appointments, classes, surgery, hospital, meds, everything came to.....$1525. No it was not all at once, $12.00 co pay for Dr. visit etc. I am thrilled that I did what I did and fought the fight.

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Mad luv and respect,
Charlie

LAP/RNY 8/20/09



"Start by doing what's necessary; then do what's possible, and suddenly you are doing the impossible."
– St. Francis of Assisi