anybody with CHA-Health Ky

Have any of you had your surgery approved through CHA in Ky. How were you treated, Just filled a first appeal Denied because they said my son is not an insulin dependent Diab. They say this is a new reason, He is IR, which means he will become a diabetic, if things don't turn around. How can they come up with a new clause, after approving for so many others. Any feedback is most appreciated. My son is a 20 year college student, 475 and 71 bmi, met all the other req. now they throw this in. Thank you Trish

Leave it to the insurance companies. I don't have CHA, but I know that the insurance companies are continually adding requirements. Mine added a 6 month doctor supervised diet. I don't understand the diabetic thing. Being full blown diabetic is so much harder to treat than it is to prevent. Oh well, leave it to the insurance companies. I have been reading about many people who file appeals and win. I would think the 71 BMI would be mroe than enough to show that he needs this. Be persistant. You might go to this site http://www.obesityhelp.com/morbidobesity/insurers2.phtml?State=KY and see what others with CHA have said about them. Hope this helps. ~Robin

I have CHA and was also recently denied because I didn't suffer from diabetes. This was not a requirement until the middle of Feb. when they ammended their criteria. I was told by CHA member services that some company did a study and found that only diabetics were helped long term by wls. It is hard to believe that they will accept one study like that. I, too, have appealed and just mailed my letter today. My PCP also wrote a letter for me asking for reconsideration. The dietician at my surgeon's office said it will probably be a hard appeal to win and they may have to quit accepting CHA patients. Good luck!

Hi Trish, I had CHA health and was denied first. Then I had to jump through their hoops and wrote my own appeal letter and did all kinds of research on the internet and other sources. I was to meet face to face with the board on a Thursday and I called them on Tuesday to see what time and they told me my denial was overturned!!! Based on my letter and other evidence, they approved me. I am diabetic but not insulin dependent. I really wanted this to happen and didn't give up. You can even appeal with the State Insurance Commission. I was going to do that if necessary! I've lost 27lb so far. My diabetes meds has gone from 5 to 2 a day now!!!! YEAH!!!! You go girl and I wish you all the luck!!! p.s. I know where Louisa is, I have friends in Fallsburg!

Just found out on Monday April 19, that my surgery has been denied by CHA(Diabetes averages not 8 or more) That is impossible to keep those averages if you take your medication and watch what you eat. I assume that they want you to die and then they won't have to deal with you. I am working on my appeal at this time. I have been so down and depressed since finding out that I was denied. Diabetes is the least of my problems. My arthritis is so bad that I cannot get around. I need help desperately and I'm afraid that they will not change their mind. I would like to meet the doctors who made up this criteria.