Question:
What are the requirements for 2003 for Ohio Med PPO (State of Ohio employees)?

My husbands insurance will be changing in the next 2 weeks due to a "significant change" in his current coverage. I am looking at Mutual Medical (Ohio Med PPO) for State of Ohio employees. I have researched the insurance information on this site but I don't see much for 2003. Since Aetna changed their requirements for 2003, I want to make sure Mutual Medical didn't change theirs also. Does anybody know what Ohio Med PPO requires for this surgery for 2003?    — Carolyn M. (posted on March 3, 2003)

March 3, 2003
I have Ohio Med PPO (SuperMed) thru State of Ohio and I am scheduled for surgery on 3-5-03 (tomorrow--YIKES!)I had my surgical consultation in early Dec, 2002 with Bariatric Treatment Ctrs./Dr. Victor Stelmak. I have been battling obesity most of my adult life and have been morbidly obese the past 3-5 yrs. My BMI is 45 currently; I have numerous comorbidities (severe deg disc disease; sleep apnea; fatigue; fibromyalgia, to name a few.. I was able to submit office visit notes from my PCP showing weight over past 5 yrs. and also dieting attempts. I listed the various diets/pills/plans I have been on thru the years. I had a letter from a neurosurgeon who evaluated me for possible back surgery and it was ruled out, but he recommended in writing that weight loss would likely help ease the pain and increase mobility. I had a positive response from Ohio Med in January; no problems in getting them to accept the medical necessity. Hope this encourages you. Suzanne Suppes
   — Suzanne S.

March 3, 2003
Carolyn, I'm not aware of any changes in OhioMed coverage for this year, but I do know that they completely paid for my surgery on July 29, 2002. I also work for the state and was approved through OhioMed three weeks after submitting my information. I had a BMI of 43 and four herniated discs, but other than that I was extremely healthy. Of course, like most on this site, I was overweight for many many years. Good Luck in your journey.
   — Lisa D.