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  631 People Lost in total 55318 lbs = 29.01 % Give us permission to add your before & after Weight Loss Photos |   |
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05-22-2007, 06:21 PM
| #1 (permalink) |
| Cub Reporter Join Date: Mar 2007 Location: Spokane, WA
Posts: 66
Weight Statistics off and on all my life nothing permanent yet... Start Date:
still inquiring with PCM Surgery Date:
Height: 226 lb Start Weight:
170 lb Current Weight:
120 lb Goal Weight:
56 lb Weight Loss:
50 lb Lb Left to Lose:
24.7787610619 % % Lost:
12/31/08 Goal Date:
Body Mass Index 42 BMI Start:
37.7 BMI Current:
22.3 BMI Goal:
  |  My bubble was burst... Ok guys I am so sad and depressed now. I was waiting for the final approval from Tricare and they denied it. I was told before they ever sent it in that I meet the minimum requirements. So I was in complete shock when I got the letter. They said I don't... according to them I have to be... "100lbs overweight with a co morbidity" or be at, at least 200% body weight". So my question is how much would 200% be? I am really confused and I am going to appeal it but I need to understand what they mean fully so I know what I need to appeal. Anyone have any thoughts???  
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Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.  |
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05-22-2007, 06:48 PM
| #2 (permalink) |
| Whipper Snapper  Join Date: Apr 2007 Location: Texas
Posts: 16
Weight Statistics May 9, 2006 Start Date:
May 9, 2006 Surgery Date:
Height: 334 lb Start Weight:
175 lb Current Weight:
180 lb Goal Weight:
159 lb Weight Loss:
-5 lb Lb Left to Lose:
47.6047904192 % % Lost:
May 9, 2007 Goal Date:
Body Mass Index 49 BMI Start:
25 BMI Current:
26 BMI Goal:
Weight Loss Method Adjustable Gastric Band  |  Thats unusual. Most insurance companies that cover WLS use the standard > than 40 BMI or >35 BMI with comorbities. I see by your signature that your BMI is 42. I wish I had an ansewr, but I am unsure either.
__________________ Banded May, 9, 2006 by Dr. Cribbins. Start weight:334 Reached goal of 180 on 02/19/2007 Currently maintaining between 175 & 180  |
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05-22-2007, 07:02 PM
| #3 (permalink) |
| Seasoned Veteran  Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 3,500
Blog Entries: 1 Weight Statistics September 19th 2007 Start Date:
September 19th 2007 Surgery Date:
5' 10" Height: 363 lb Start Weight:
221 lb Current Weight:
165 lb Goal Weight:
142 lb Weight Loss:
56 lb Lb Left to Lose:
39.1184573003 % % Lost:
12/31/09 Goal Date:
Body Mass Index 52.0793877551 BMI Start:
31.7067346939 BMI Current:
23.6724489796 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | I have TRICARE standard. Is this what you have or is it prime? Becka has prime. I got approved. There regualations are a bit different than some others. You do have to be atleast 100 lbs overweight with at least 2 Comorbiditys. Hypertenstion, Diabetes, GERD, Arthritis in weight bearing Joints, and there is one more I can remember right now. At least 2 of them have to be met. If you call TRICARE they will tell you exactly what you need and how to go about appealing it. Im sorry this is about all I can offer. The 200 % would be you weighing 200 lbs over the last lb before obesity I think. |
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05-28-2007, 06:53 AM
| #4 (permalink) |
| Guru In Training  Join Date: Apr 2007 Location: Maryland
Posts: 341
Blog Entries: 1 Weight Statistics 6/14/2007 Start Date:
6/14/2007 Surgery Date:
5' 4" Height: 330 lb Start Weight:
198 lb Current Weight:
150 lb Goal Weight:
132 lb Weight Loss:
48 lb Lb Left to Lose:
40 % % Lost:
June 2009 Goal Date:
Body Mass Index 56.6381835938 BMI Start:
33.9829101562 BMI Current:
25.7446289062 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | I'm so sorry! I think that 200% would basically be double the weight at which you'd become normal weight, so maybe 240, since you'd be a 25 BMI at 120lbs? Not quite sure if that makes sense. Then again, the insurance companies don't make sense. Good luck!
__________________ Cindy  |
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