Medical Mutual (Supermed ...

Medical Mutual (Supermed Plus) Insurance - Does anyone have this insurance? Were they (Medical Mutual) easy to work with getting approval for surgery? How long did it take to get approval for surgery?

Michelle, MMOH paid all but $1500 for my surgery and hospital stay. I only had to pay $1500 because my surgeon wasn't in network. It only took a few weeks to get approved on the first letter. I got an approval letter from MMOH before the surgeon's office did. I called the office to get a date and they had no idea what I was talking about, lol. About a month after my surgery I got a letter from MMOH stating that they have a maximum coverage of $10,000 now. That may just be our policy change though. Good Luck!! I'm hoping they'll cover my reconstructive surgery.

Jessica, Thanks for the information. I just checked with the lady in charge of our benefits here at work, and she said that there is no maximum coverage right now with our plan. But a doctor has to prove that the surgery is necessary. I have a low BMI, but I do have high blood pressure, and back, hip, and leg problems. I also have mitral valve prolapse. My heart doctor gave me the ok for the surgery. So I guess that I will just have to wait and see. My doctors office should be submitting my information to the insurance company in the next two weeks.

I have Medical Mutual of Ohio SuperMed Plus with Accordia National. My HR person said we do not have a maximum coverage. There is a yearly out of pocket if he is not in the network. Cleveland Clinic and St Vincent are in the network. I plan to go to Bariatric Treatment Center in Columbus. They maybe out of network so I am looking at that 1500.00 out of pocket expense. I know I need 5 yrs of medical history of being over weight. I have arthritis, lower back pain, sleep apnea, hand,arm, leg numbness. My BMI is almost 56. I've heard they are easy to deal with.

Hi Robbin, I have not applied yet with Medical Mutual. My BMI is on the low side. It is 37.0. I have heard that they fight to approve people with low BMI's. I do have high blood pressure, hip, leg, back problems also. My doctor should be submitting to my insurance company in the next two weeks. So I guess that I will have to wait and see. The doctor that I have is in my network. Medical Mutual pays 90%, I pay 10%. Thanks, Michelle

Robbin, my surgery was performed at Bariatric Treatment Center in Groveport (Columbus) and the hospital itsself was in network, but the surgeons aren't. My surgeon was Dr. Patricia Choban and I really liked her, but she has since left BTC . If I had known she wouldn't have been here a year later, I may have gone with another facility or surgeon. My hospital experience was a great one. I couldn't have asked for a more caring, supportive staff. There was never a time that I didn't get something that I needed. The nurses were very attentive. Good luck to you! ~Jessi

The BTC representative told me they have plastic surgeons coming to all the facilities in a year. I have 5 yr of documented weight history. But some plans require supervised weight loss. Has anyone run into that? And how does that work?

ROBBIN, FOR ME THEY WANTED 5 YRS. OF WEIGHT HISTORY AND ANY LAB WORK DONE TOO. ALSO, THEY DID WANT SOME KIND OF WEIGHT LOSS MANAGEMENT DOCUMENTED FOR 1 YR. BUT, I'M SURE THINGS HAVE CHANGED IN A YEAR. GOOD LUCK SHERRY RAVENNA, OHIO

July (?) of 2003, Medical Mutual put a $10,000 lifetime cap on weightloss surgery. I've postponed mine to July of this year in order to come up with the $5,000 (up front) that St. Vincent's wants. The anesthesiologist is my responsibility too, but that will be paid after the surgery. Otherwise, MM was okay....lost my papers once, they were re-sent. I was denied but one my appeal with letters from my primary doctor and gyn. Total time was 8 months from application to approval. Don't let the cost change your mind. Keep your determination and save your cash! Good luck to you.

HELLO MICHELLE, I HAVE THAT INSURANCE CO. THEY ARE WONDERFUL! MAKE SURE YOU HAVE A PERSON THAT WILL TAKE CARE OF YOUR CLAIM. IT MAKES IT EASIER. ASK WHAT THE INS. EXPECTS YOU TO DO. I HAD TO GET A PSYOLOGICAL EVALUATION DONE. I THINK THAT IS EXPECTED TO DO NOW. ALL I HAD TO PAY OUT OF MY POCKET WAS $400.00 THAT WAS MY CO-PAY. I THINK THAT HAS CHANGED NOW? BUT, SOME TIME LATER I GOT A CHECK BACK FOR $79.00. ONCE THE LADY THAT TOOK CARE OF MY CLAIM GOT MY PACKET I GOT APPROVED IN 3-5 DAYS! IT TOOK THEM SOMETIME TO RECEIVE MY PACKET BUT, ONCE SHE GOT IT, IT WENT VERY FAST! LET ME KNOW WHAT HOSPITAL YOU ARE GOING TO. I KNOW THAT ST. VINCENT IS A EXCELLENT HOSPITAL WITH EXCELLENT DOCTORS!! GOOD LUCK TO YOU! SHERRY RAVENNA, OHIO