Tricare lap-band revision from Texas

[hilary1617]

Hi and welcome @Ellie Mae . I'd recommend the DS - one revision is more than enough! All the best!

 

[Ellie Mae]

At this point in time, your only option for a Tricare covered revision without a "real medical issue" (as if a BMI of 50 isn't!!) is through a MTF. There are only a couple in the country that have/had DS surgeons in place. Madigan in WA is/was one, and I recall reports of one at the major MTF (is it still Navy?) in San Diego and in Ft. Bragg.

If self-pay is an option, your best bang for the buck in a skilled surgeon is Dr. David Greenbaum in Moorestown/Mt. Laurel/Mt. Holly, NJ. I believe he now operates under the umbrella of Virtua Surgical Specialists.

You probably already know this, but DO NOT GO OUT OF COUNTRY for a self pay revision (or any other procedure) when your only insurance is Tricare. You'll be screwed for any followup or complications coverage, quite possibly forever. They definitely won't pay for a durned thing out of country unless it's in a duty location on an accompanied assignment.

So I'm more than happy to travel to a MTF. But I would have no idea where to start. Should I switch to prime when I can?

 

[Whit]

Hello welcome to the group.

I revised for RNY to DS. Tricare was my secondary insurer. They only covered if my primary deemed surgery medically necessary and approved the procedure. At the time, 4.5 years ago, they would not cover any bariatric surgery. Policies may have changed since then. Dr K. was my surgeon and his office handled approvals for me. I am not sure they do that anymore. If traveling is an option you may give his office a call. I traveled from Northern CA.
Good luck!

 

[Elizabeth N.]

So I'm more than happy to travel to a MTF. But I would have no idea where to start. Should I switch to prime when I can?

I don't know what a good answer to that would be, as I have no clue how Prime operates. Standard has the widest coverage of any of the plans, both geographically and in terms of services, but I don't know anything about getting involved in care with a MTF as a retiree or retiree spouse.

I'd suggest calling Tricare and having a nice long conversation with someone pretty far up the food chain in the benefits department. Better yet, if you have a VA facility near you, find someone there who can steer you to the experts. (Well, better IF you have a GOOD VA like we do.)