Medical Mutual of Ohio Insurance

I am so angry and I'm not gonna' take it sitting down! My insurance company, Medical Mutual of Ohio, approved me for gastric bypass surgery on June 5th, 2003. My surgery was scheduled for June 30th. When I went to the Bariatric Treatment Center for pre-admission testing on June 9th, I learned that the benefits for WLS were being reduced effective July 1st, to $10,000 lifetime maximum. I was NEVER notified that there would be a reduction in benefits. Neither my husband's employer nor their benefits group were notified that MM would be reducing benefits. Medical Mutual of Ohio insurance has effectively launched a campaign of discrimination against an entire class of their own policy holders by reducing benefits available for gastric bypass surgery. I think it's important to note that only those individuals who are morbidly obese would require gastric bypass surgery. The fact that these individuals have been singled out for a reduction in benefits is blantant discrimination. I want to urge anyone reading this post to contact: The Ohio Department of Insurance Consumer Services Division 2100 Stella Court Columbus, Ohio 43266 AND COMPLAIN!! File a complaint about unfair insurance practices. Complain about discrimination against the obese. 1. Demand that Medical Mutual of Ohio Insurance explain the principal reasons for the reduction in benefits for the treatment of morbid obesity, specifically bariatric surgery, and ask them to provide an explanation of the clinical rational for the decision. 2. Demand that MMO provide documentation that they notified all the affected benefit groups about the reduction in benefits for gastric bypass surgery before the reduction in benefits took effect. 3. Let them know that MMO's reduction in benefits for the obese has excluded us from medically necessary healthcare and demand that MMO restore full benefits for gastric bypass surgery. MMO has failed in their obligation to provide acceptable and adequate service. Write to Medical Mutual of Ohio Insurance and demand the same things: Medical Mutual of Ohio Insurance 2060 E. Ninth Street Cleveland, Ohio 44115 Above all, do NOT remain silent on this issue. Write your state representitives, contact your local media, TV, newspapers, ACLU, anyone that will give you a voice and SHOUT for your rights!!!! Size discrimination condemns morbidly obese people to be excluded from access to medically necessary, quality care. Such discrimination and consequent exclusion is unacceptable. You can email me at [email protected]

Just a word reagrding #2: There is probably a sentence or two somewhere in the policy that says they can make changes to the policy at any time, and they don't need to notify members. I do think your other points are valid and do deserve explanation. If they say that the surgery is partially for the sake of appearance, then ask if they cover breast reduction surgery in the same way. Best of luck!

I just received my approval letter today. Towards the end of the notice it states that coverage might have changed effective July 1 and to make sure of my coverage, I should call to see what my particular policy states. I called and found that I still have 100% coverage since my surgery is considered a medical necessity. Every Medical Mutual of Ohio policy is not the same. For the record, I have Super Med Select. I do agree with the points you made, especially concerning discrimination. You might also contact your State Senator and ask him/her to support Senate Bill 41.