Medical Mutual - do you know?

Hello Everyone, I was wondering if anyone here knows about Medical Mutual. If so can you tell me what their requirements are, if you had to "fight" with them to get an approval and what hospitals and surgeons they cover. Did you have a good experience with them? Are they hard to deal with? Thank you!

Hi! A lot depends on your plan. I have HMO HealthOhio. They require a 6 month supervised weight loss attempt with your doctor, a psych evaluation, a 5 year weight history, and all attempts of past attempts of weight loss ie. weigh****chers, jenny craig, diet pills etc. also must be medically necessary. I would call them and ask them. One of the members here has MM and a different plan and they did not require her to have a 6 month supervised weight loss with her PCP.......best thing is to call them directly and ask! Even within plans they could be different depending on the aggreement with the employer. Once all my papers etc were submitted it took them 5 days to approve my surgery. I don't have any complaints about them! Sue

My experience with medical Mutual was completely different from Sue's. It was a nightmare. They okayed the surgery for one of my co-workers...some one with the exact same policy I have,then they denied me 3 times...required plastic surgery counseling which they did NOT require of my friend, and accused my PCP of fabricating my documentation among MANY other things. It was not until I employed a lawyer and requested an external review did they overturn my denials. I fought with them for over 9 months to have my surgery and I have to say that some of my darkest days were because of them. I sincerely hope you have the experience Sue related, and not one like mine. It really caused me to question my self-worth. Liz Hillsboro

Hello Female, I had Medical Mutual and my experiences were not that great! I feel that they try not to cover when they should. They kept losing paperwork so my advice to you is document, document,document. Make copies of everything before you send anything. If you have any questions, please feel free to ask. Richard

Read my profile. I have a terrible experience with Medical Mutual. They were deceitful and threw whatever they could into my path rather than cover things. if not for my choice to self-pay Medicare from when I was on disability, I would still be taking 14 drugs, still be grossly overweight, still be marching slowly toward an early death. Their idea of help was to offer me phone counseling at their expense for depression, diabetes, and weight issues. The last full year of my weight, they laid out thousands of dollars in medications, apnea, blood pressure, and diabetic supplies. The first full year after surgery, I cost them less than $200 and that was for bladder infection medication. My profile is sprinkled with generous doses of my ongoing fight with depression and post traumatic stress issues, so it is dark at times, but even though I have toyed with deleting it, have decided it stays because although I wish I was different, it was who and what I was. Things about this journey are just not pretty: the fights we have to wage in order to find respect and be given the help we need, the feelings we struggle with 24/7, the family difficulties, the doctor searches....but all of it is important to our identities, I guess. The ugly, the bad, and hopefully, eventually, the good too. Best of luck. As was already said...document everything...times you call, to whom you speak, length of conversations. Just script everything or if possible, tape record! And many of us have fought this battle - so ask for help and insight, as you have done here. People can help you be successful. So many people rallied to help or support me. It gave me courage to keep fighting when I felt tired and lost. You are very much worth it. Maryalice