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Tricare now covers 'Lap-Band' surgery

FALLS CHURCH, Va. (AFRNS) -- Tricare beneficiaries whose weight poses a serious health risk now have a new surgical alternative available. For those who medically qualify, Tricare now covers laparoscopic adjustable gastric banding, also commonly called Lap-Band surgery. Although the Tricare policy change has only recently been made, coverage is retroactive to Feb. 1, 2007.

"We at Tricare are careful to only cover procedures that have been proven safe and effective, and are accepted by the medical community," said Maj. Gen. Elder Granger, deputy director of the Tricare Management Activity. "We've added this procedure because, for some beneficiaries, it may be the right course of action to preserve their health."

General Granger adds that, like gastric bypass, gastric stapling or gastroplasty, Lap-Band surgery is only for those suffering morbid obesity. In medical terms, that means their body weight is 100 pounds more than the ideal weight for their height and bone structure, and their weight is associated with severe medical conditions known to have higher mortality rates. Body weight that is more than twice the ideal weight for the person's height and bone structure may also indicate morbid obesity.

Tricare will also cover the surgery if a patient has had an intestinal bypass or other surgery for obesity and, because of complications, requires a second surgery.

Details of the coverage are available in the Tricare Policy Manual, which beneficiaries can view online at
http://manuals.tricare.osd.mil/index.cfm?fuseaction=TMAManuals.DisplayManualSeriesInfo&ManualSeries=POLICY&TP02=67#TP02. A search for "morbid obesity" goes directly to the correct section. (Courtesy of Tricare)