TO: Fresno Unified School District Employee Health Care Plan Participants in PPO Plan Options A and B (including Non-Medicare Retirees)
DATE: October 19, 2019
In a recent board meeting, the Joint Health Management Board formally decided to discontinue its planned surgery benefit partnership with BridgeHealth effective January 1, 2020. Plan participants with surgeries scheduled through BridgeHealth between now and December 31, 2019, are not affected – so long as the surgery is approved and completed by December 31, 2019. However, if you have yet to schedule a surgery with BridgeHealth, read below for more details on your options.
If You Have Not Yet Scheduled a Surgery Through BridgeHealth
If you are still considering an upcoming surgery, we suggest that you contact BridgeHealth at (844) 567-2970, as soon as possible. It usually takes between 4-6 weeks for the intake and scheduling process to be completed. The procedures covered under the existing planned surgery benefit program include:
- Bariatric (Gastric bypass, gastric sleeve, lap band removal)
- Cardiac (Coronary artery bypass graft, valve repair and replacement)
- General (Gall bladder removal, hernia repair)
- Orthopedic (ACL repair, hip and knee replacement, shoulder repair and replacement)
- Spine (Spinal fusion, artificial disc replacement)
- Women’s Health (Hysterectomy)
Any surgeries completed through the BridgeHealth program between now and December 31, 2019, will continue to be covered at 100% (including the travel allowance). However, any surgeries completed on or after January 1, 2020 will no longer be covered under this planned surgery program and will be subject to the prior-authorization process of the Anthem Blue Cross PPO network, as well as the deductibles and copayments/ coinsurance under the District’s PPO Plan Options A and B.
Thank You for Your Understanding
The Joint Health Management Board strives to provide benefit offerings that improve the healthcare outcomes of our plan participants while also helping to control our overall healthcare costs. We will continue to survey our market options to identify and implement programs that serve these strategic goals.
