Question:
Should I keep Anthembcbs or switch to Mplan by Friday
I have the option this year to keep anthem bcbs or to switch to mplan. I have to do it by the 28th only a few days. I don't know which is more likely to cover. I appreciate any help. — Krystal W. (posted on April 22, 2002)
April 22, 2002
I have been having HORRIBLE problems with Anthem, and I know others who
have had the same. I'm not familiar with the other plan, but try doing a
search under insurances. Good luck!
— Sarah P.
April 22, 2002
Is there a way to get a look at each of the policies? It seems that you
would need these to make an informed decision. I was approved by Anthem
BC/BS without any problems whatsoever. They required a 12 month diet
history (MD supervised) and that was about it. It was really a simple
process. Good luck to you. Shelley
— Shelley.
April 22, 2002
Just a thought.. I believe that M-Plan requires 18 months of consecutive
dieting. I have heard good and bad on both ends. You should go to IN
insurers and read up on both. I chose CIGNA over M-PLAN and it ended up
being the right choice for me. Good Luck!
— Beffy W.
April 22, 2002
I have m-plan... so far I have been denied. They require 6 months of
doctor supervised weight loss attempts.. I have been denied due to lack of
documentation.. partly my PCP's lack of enthusiasm for WLS (my honest
opinion).. And you have to prove medical nessesity...
— Angela G.
April 22, 2002
Well, I guess it matters what plan you have as well. I am showing 18
months of diets and someone else is showing 6. I spoke to a friend who has
had M-Plan through 2 different employers and both plans varied in many
ways... sorry to sound so confusing... Good Luck and keep us updated on how
you are doing...
— Beffy W.
April 23, 2002
I had Anthem BCBS and although they did require the 6 months of documented
physician monitored weight loss, a psych eval, once I had that, they
approved after the first letter. No fighting about it at all. I know
nothing about M-Plan.
— Shona M.
April 23, 2002
Well I had a horrible experience getting Anthem BC/BS to approve me even
though I had bmi of 63 and 6 of the 7 comorbidities that would qualify you
for WLS. But a lot of it has to do with you specific employers policy and
circumstances. My employer, which is self insured, was going through Ch. 11
bankruptcy at the time, and I believe they told the insurance co. to deny
my surgery no matter what, which they did until I hired Walter Lindstrom to
file a level 2 appeal and which he basically threatened both Anthem and my
employer with a discrimination lawsuit. I was approved 3 days later.
I don't know anything about MPlan, but I would ask for the plan specifics
and go through them with i fine tooth comb.
— Dell H.
April 23, 2002
I got approved very quickly with Anthem BC/BS. However, the real answer to
your question is that the only way to know which one is the one you should
choose is for you to look at both policies. I know you don't have much
time, but insurance policies and laws vary from one state to the next.
Even the same insurance carrier can have two very different plans for two
different employers in the same state. Unfortunately, there is almost no
way to give absolute answers to any insurance coverage questions.
— garw
Click Here to Return