Bluegrass Family Health

Has anyone heard that BFH is no longer approving surgeries for anyone except State Workers? I have heard this from several different people. I called the insurance company anonymously the other day and asked if it were true and the lady said, "Absolutely not, that it all depends on if it is a medical necessity." I'm worried that they are doing that but can't tell people. Any advice would be great. I'm affraid I am going to get my hopes up and be very disappointed. Thanks! Melissa

I got approved by Bluegrass Family Health back at the end of August and am having my surgery October 6th. I didn't even attempt to get approved until I had my proof that I'd attempted weight loss. I did weigh****chers for 6 months and then the doctor's office submitted my paperwork and I was approved the very first try. Hope that encourages you a little. Karen

Karen, thanks so much for replying. Congratulations on your surgery date! The sixth is tomorrow, OH MY!!! I'm so happy for you 8*) That does give me encouragement. I do have documentation of weight loss but it is through a program here called Pounds Away. I've got my cards from where I weighed in each time and the lady that is over it also wrote me a letter. The clinic has been open now for about 15 years. Do you think that will be sufficient? Thanks Again and Congrats!! Melissa

Oh and I do have 6 months straight of weigh in's. Melissa

Go for it!!! You will not know until you try!! Even if you are denied you can appeal!! Now get busy girl!!! Blessings Tonya

Tonya, Thanks so much for your words of encouragement! Melissa

Karen, Did you say you weren't a State Worker? Thanks for all the advice! Melissa

MELISSA, I ALSO HAVE BLUEGRASS AND AM TOLD THAT THAT IS TRUE. THAT EVEN IF YOU ARE FOUND MEDICALLY NEEDY THEY WILL NOT COVER. WHICH IS INSANE. DON'T INSURANCE COMPANIES REALIZE THAT IF YOU HAVE A STROKE THAT THE HOSPITAL STAY ALONE WOULD BE THE COST OF THE SURGERY?!?!?!??! LM

Thanks so much! You are right. I called them again today and asked to speak with someone to find out if a procedure was covered. I asked her if it were true about the state employees being the only ones covered for WLS and she said yes and told me that my plan would not pay anything because there is an exclusion. Can I stop my enrollement with this insurance? They don't have us in the computer yet. Can I get Individual Insurance even if I decide not to enroll in the group plan? Thanks Again! Y'all are great!! Melissa

Just read your post, I have BGFH and am a state worker. I had not heard this but nothing surprises me about BGFH, I have been trying for a year and finally got approval last week. I have heard that the state is changing to Humana next year. Gail