Re: Back from Doctor.. Insurance

January 14, 2004

Thanks Candi and Joan,

I am going to call my Tricare Service center, because I found this

on my insurance papers

TRICARE Fast Facts

TRICARE will cover surgery for morbid obesity. Morbid obesity means

the body weight is 100 pounds over ideal weight for height and bone

structure, according to the most recent Metropolitan Life table

statistics. Obesity has been associated with severe medical

conditions known to have higher mortality rates in association with

morbid obesity. The morbid obesity benefit is limited to the gastric

bypass, gastric stapling or gastroplasty, to include vertical banded

gastroplasty. TRICARE/CHAMPUS payment may not be made for

nonsurgical treatment of obesity, morbid obesity, dietary control,

or weight reduction

I bout fell out when I read that tricare will only cover surgical

weight loss procedures, I guess they don't like to waist time with

pills and all. SO I am going to see if I can either get a NAS which

is a non availability statement whichs will allow me to go to

whatever doctor my doctor refers because there are no available

doctors in my 50 mile rage that accept tricare, or see if I can go

to one of the basese I am near, Maxwell AFB or Army in Fort

Benning, both have Family practice and do all outpatient surgeries

there, inpatient there send me to the hospital they work with.

Anyway, my soctor yesterday said he would refer me if I could find a

general surgeon who took my tricare, but I am going to call my

insurance and let them set it all up. I got a headache!!! Military

can be difficult!!

About the diabetes, I have had alot of folks tell me sounds like I

was getting that, omg scary!! And then I found out my great aunt and

grandmother has them, and I never knew that. And I a not sure my

doctor checked for that yesterdat. My mom said they have to do a

different kind of test to check. I have an appointment with him in a

month, should I wait til then to ask about the diabetes test or call

tomorrow and tell him about how I have been getting dizzy when I eat

and that I found out it is in my family???

> if you are going to the bathrom 3 times an hour you may

want to have

> a glucose test. When my diabetes first came on that was the first

symptom.

>

> usually your doctor (at least this is how it worked for me) puts

in a

> referral and the insurance company will call and set the

appointment for you

> with a Dr. in their network. I had already checked them all out

and so I

> knew which one I wanted to see.

>

> Candi

> Back from Doctor

>

> Well good news and bad news.......Well I am not 220 pds, I am 241

> pds. I about freaked out, because I don't look any different, the

> doctor looked at me when I asked about a gastric bypass and said

I

> wasn't big enough but then the nurse said yes she is her bmi is

42

> she is 241. HIs mouth fell open and said I didn't look it at all

for

> being 5 ft 2. I told him I couldn't believe it. I have put on 35

pds

> in only a few months. so he is checking my thyroids and all that

> stuff. I am getting dizzy every time I eat and peeing 3 times

every

> hour I am starting to worry about diabetes. I didn't even know it

> ran into my family til after I got back from the doctor. My

family

> doesn't really Keep in touch! The doctor said he could refer me

to

> the surgeons he knows but they don't take my insurance, so I

have to

> hunt a surgeon down that takes my insurance and call him to refer

> me, or do I need the doctors referral?? Can't I just call the

> surgeon and tell him I am 241 5 ft 2 with bmi of 42 and get me

in???

> I gotta lose muscle and fat to lose my weight, any ideas on how

to

> lose muscle....the walking actually put weight on me, that sux

huh!

> My blood pressure was elevated and he heard a heart palipitation.

> Can anyone make any of this clearer for me!!!

>

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January 14, 2004