DOES anyone have M-Plan?

I was trying to read on the isurance page about M-Plan and their approvals, but they are like a year or two old. How hard is it to get approved. anyone have any trouble?

Tracey, I waited, hoping someone would reply to you. I HAD MPlan but switched to Anthem Jan. 2004. I know you were looking for some information more recently..but I doubt they have changed their policies too much since then. MPlan turned me down in 2003...and turned me down again when I appealed. I had 30 months of pcp supervised dieting but they didn't like the way he kept his notes so they wanted me to do an additional 18 months! With the SAME doctor!?!?! Like he was going to suddenly change his note keeping style?? Anyway, I switched to Anthem and they had no problem with his style. I would advise anyone, regardless of which insurance they have, to call the insurance and ask them to send you guidelines of what all they require...and what kind of details need to be included in your pcp's notes, in any journals of your own. At that time, MPlan required 18 months pcp supervised dieting, dietician visits, weight records for last 5 years showing obesity for that entire period...among other things like letters from doctor, surgeon, etc. Indiana state law has made it to where insurance companies can only require 6 months pcp supervised dieting now...BUT....that doesn't become effective until the insurance carrier renews the policy with the insurance holder (ie. your place of employment). Good luck. And just because I didn't have a good experience with MPlan, don't throw in the towel. Just get your boxing gloves on..ok? Sherri

Hi Tracey, What network are you in? I am in the Methodist network and they do a whole new thing with the approval process. You have to sign a contract and do an 18 month program. The law in Indiana has changed so that people only have to do 6 months but insurance companies don't have to comply until they renew with your employer. Most of them do that in January. Your first step is to see your PCP and get a referral for a bariatric surgery consult. MPlan will reject the referral and they will send you the contract and guidelines for the program. Just follow the program to the letter. I did and I am having surgery on the 24th. It was a long 18 months but I learned a lot and feel very well-prepared. I also lost 30# in the process. I haven't updated the MPlan approval process on OH yet because I don't want to *jinx* myself and have them take away my approval! Good luck to you, Johnnie

Thank you for the information, I have the 18 months PCP. I had them send me guidelines and I meant them, but I still a little worried. I have SHO-Boone.