Insurance issues are in my way!
I have Coventry of DE. I am a Maryland resident and our business is in Maryland. However; I am covered under a small group (we are self employeed with only 5 employees) and they tell me that small groups are not covered because they say we cant afford the premiums for WLS. Can anyone tell me how to find out if Marylands mandate or law says that they dont have to provide the coverage even if it is medically necessary. I have to get through this hoop just to get in with a surgon...I think. Any help is appreciated!
Kelli-
I'm sorry to say there is no mandate that forces insurance companies in the state of Maryland to pay for WLS even if there is a medical necessity for those in a small group policy, which you fall under as self-employed. There isn't a loophole hole right now in the MD law unless there is something in your policy itself that says it will cover for medical neccesity.
Michelle Engelmann
Vice Chair
Maryland State Task Force to Study Utilization Review of the Surgical Treatment of Morbid Obesity