Kyra112

Tricare: How long did it take...

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I am so relieved that there is no 5 year requirement. I have Standard and crossing my fingers. I'm actually just confused about how much does Tricare pay out to out of network. Is it the "allowable" amount of do they pay everything (except the 20 or 25% of course). My surgeon's office is really confusing me telling me Tricare does not pay much.

The lady at my surgeon's office told me that since im triwest standard, that i will be paying 25% out of pocket for everything, UNLESS i get Tricare to "refer" me themselves then i pay just 20%...it actually really confuses me since the standard protocol doesnt require me to have any sort of Referal on the plan that im on, so im not too sure, i get different information from all angles, and quite frankly at this point, ive had the runaround so bad id rather jsut pay the 25% then go through any more time of trying to figure this stuff out MYSELF. :rolleyes: its just a crazy process for me, and the littlest things are tripping me up because NO bariatric surgeon in the state of Alaska seems have ever worked with a Tricare Standard patient, just Prime, so they dont really get how it works.

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I understand your frustration. Dealing with Tricare in New York City is horrible. Hardly no one accepts it and there are no MTFs nearby. You tell them you have Tricare and they look at you like you are an Alien.

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I understand your frustration. Dealing with Tricare in New York City is horrible. Hardly no one accepts it and there are no MTFs nearby. You tell them you have Tricare and they look at you like you are an Alien.

oh my gosh i kno! its like, they are all helpful and willing to make an appointment with the surgeon when you first walk in, and then as soon as you tell them "Oh i have Tricare" they ALWAYS go "Ohhhh, well in that case, you need to do this, and this and this and that and contact this guy and contact that guys mother and jump over the moon a couple times and then we'll see what we can maybe do for you. Come back when YOU'VE got it figured out."

and its like, okay uh thanks i guess.

UGH! i went through 6 months of that B.S. and then FINALLY i found a surgeons office that was like "This is going to be a bit difficult to figure out, but we'll contact you when we have it figured out."

And I thought that was another dud until one hour later, long behold the lady actually did her job, and got me an appt. after sorting out my insurance.

Let me tell you, you don't appreciate someones hard work and commitment until youve been put through the ringer with others with the same job title but different ethics.

Cheers for Tricare rants! :P

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oh my gosh i kno! its like, they are all helpful and willing to make an appointment with the surgeon when you first walk in, and then as soon as you tell them "Oh i have Tricare" they ALWAYS go "Ohhhh, well in that case, you need to do this, and this and this and that and contact this guy and contact that guys mother and jump over the moon a couple times and then we'll see what we can maybe do for you. Come back when YOU'VE got it figured out."

and its like, okay uh thanks i guess.

UGH! i went through 6 months of that B.S. and then FINALLY i found a surgeons office that was like "This is going to be a bit difficult to figure out, but we'll contact you when we have it figured out."

And I thought that was another dud until one hour later, long behold the lady actually did her job, and got me an appt. after sorting out my insurance.

Let me tell you, you don't appreciate someones hard work and commitment until youve been put through the ringer with others with the same job title but different ethics.

Cheers for Tricare rants! :P

:D That is too funny! and sad but true LOL

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My Journey 6/5/2010

Hi Im Nicole and Ive begun my journey-

My doctor and I talked about the bypass in the fall of last year (2009) . We are currently at Ft Riley Kansas and my referral went to Dr Hachem and the Innovative Weight Loss Gals - huge thanks goes to them! My approval wasn

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As far as the 5 year history, I didn't have any issues with Tricare. They weren't pulling it from records, but asking for a history of what issues with weight / weight loss that I had gone through over the past 5 years. They didn't require any back up documentation, although they would have been able to verify most of it directly out of my records if they had checked. The whole approval process with Tricare was extremely easy (even my doctor said that Tricare is easier to deal with than most providers...first time I ever heard that!) and fast. I saw my PCM in early November, they referred me to a surgeon for a consult. Their earliest opening was two weeks later. I got approval for the surgery within a week, and we scheduled the pre-op for December 1st and surgery for December 21st. Bing-Bam-Boom.

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So I got my referral put in oct 31,2019. It's been almost two weeks and they called me which the weight seminar is on dev 3,2019. So it's been over a month since my referal when dec 3,2019 comes. How long is the usual process after the weight seminar to get everything done

 

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Welcome to Thinner Times Samantha.

I wish I could help with the Tricare timeline but they seem to differ.  Having said that, I'm fortunate in that all my medical care is done at a military treatment facility.  The seminars/classes took close to 5 months to complete before I was given a surgery date (2 weeks or so later).

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