Question:
Anyone w/ BC/BS of MD POS with written exclusion, gotten approval ...................

after there first appeal.. I was denied after my first letter to the Carefirst BC//BS of Md {points of service} I have an written exclusion stating Medical or surgical treatment for obesity, unless otherwise specified in the covered services; Medical or surgical treatment or regimen for reducing or controlling weight, unless otherwise specified in the covered services Any tips or suggestion would be appreciated Thanks, Susan B [email protected]    — Susan Rainey-Harris (posted on July 22, 2002)


July 22, 2002
Hi Susan, In Maryland there is a bill that says Insursnce companies doing business in Maryland must approve this surgery, HOWEVER, if your company is "self-funded" or small they are excluded, BUT you can still fight or work with the employer to have it overturned, they would be the ones to do it. I had that situation and worked with the HR department of my husbands employer and got approved. If you are not familiar with this law, let me know, but if you are not sure of this, call your ins. co and ask them if they are aware of this law...they will tell you if the employer is exempt..if not they will have to approve you then and their, unfortunaltely some companies like to "try" you to see if you know your rights, sad, but true!
   — Patricia R.




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