Question:
has anyone been approved by M-Plan Prohealth???

I talked to my pcp about bariatric surgery, he thought it was a good ideal. He gave me a referal to see a surgeon, but that surgeon dose not accept M-plan prohealth. I can't find a surgeon that does. The surgeon said he could get me an out of network referal, but M-plan denined that. I don't know what to do next! I cant even get in to see the surgeon!    — Christina S. (posted on April 17, 2001)

April 18, 2001
When I read your question, my first thought was to check with those in your state that have used your insurance and ask them what surgeon they used. At the top of any page click on "insurers" and then click on your state, Indiana. You will then get an alphabetical list of insurance companies that have covered this surgery for particular patients. There are actually two sections of "Mplan", one at the beginning of the M's and then further down the list.(FYI-most seem to get approved!) There are many listed and while they may not be your exact plan, there are e-mail addresses(no names) of those patients that used that insurance. Maybe you could e-mail them and ask particulars about the policy and find out what surgeon they used. It's a start. It may be a little time consuming, since many may not be from your area. But it is a start and I think it would be beneficial to locating a surgeon that accepts your insurance. Also, with my insurance, I can call my customer service rep and ask what surgeons are in my plan. If there is truly no one in my network that performs a particular surgery, then I can go out of network and receive benefits at the in-network level. I hope this helps.
   — Shelley.