Medical Mutal AGain

Hi I just wanted to get the experiences of anyone who has Medical Mutual Super Med Plus. I know this has been addressed before. I'm just having huge issues with them 1. I have medical records showing morbid obesity for 1999, 2003, and 2004. I have dated pictures from 2000, 2001, and 2002. 2. I have about 2 1/2 months supervised weight loss. This doesn't include the 14 plus years of WW, Jenny Craig, Richard Simmons etc. 3. They keep trying this pre-condition stuff like I gained 150lbs overnight. My doctor has writted 4 letters. Acordia National claims they never received them and they have their own form that must be filled out. Yeah tell me that after 6 months. I have 8k of medical bills that they are fighting to pay because of pre-exisiting. They want to fight the sleep test, the EEG, the EKG, the endocronologist, the blood work its driving me crazy. So I just want to know from anyone who has Medical Mutual of Ohio what you did to speed up the process and how you got around their games.

They will try to do anything to keep from approving anyone. I have been fighting with them for months now, and they still continue to deny me. Have you been told by them that you must have a BMI of 40 or more for the last five years? I was told that. I dont have a BMI of 40 and never have. My BMI is 38.9 with comorb's (high blood pressure, mitral valve prolapse-heart) and they still give me the run around.

I applied with Med Mut Super M+ and was denied. Appealed and was accepted but Med Mut started their $10,000 life time limit for weightloss surgery while my appeal was being processed. I've had to postpone the surgery to come up with $5,000 the hospital wants; the anthesiologist will be a separate bill I must pay. The finance person at the hospital told me that MM is expected to STOP COVERING the sugery completely in July! I hope that is next year but I'm not sure. I also know that they have started to deny tummy tucks, etc. All I can say is good luck and push them hard. Try to get your doctor more involved too.

Ann, I also have Medical Mutual +, and they just recently put a 10,000 cap on our insurance, but my employer has a deal with them that if someone was already in the process, it does not apply to them. You may want to check on this with your situation. I was also denied and appealed and denied again. I am just kinds not knowing what to do now.

i have medical mutal supermed plus i just recently had my surgery i was approved in november of last year i only had to submit my 5 year weight history psych eval i have noticed from the message boards that mm is getting stricter with there criteria also with placing the $10000 cap on this i had no trouble what so ever in my process for approval it was submitted and approved in 2 weeks time i did not get the approval letter for 4 weeks but the date on the letter said it was approved with in two so far have not received any bills from the hospital yet only my eob's have come according to these they have sent out payment i ony have to pay my copays good luck seeking your approval