Maryland Law supporting Surgury?

Hi Tony, I have CareFirst BC/BS PPO. My insurance is through my husbands employment. He is now retired but worked for Baltimore City Fire Dept. I picked my doctor (DVR) and went to the info session. His office took care of calling the insurance company to see if I was covered and what the insurance company required to get an approval. The office personal said it would be better for them to call because they know who to talk to and what questions to ask. I am covered but I am on a 6 month supervised diet with DVR's office before I get approval. Hope that helps and good luck to you wife on her journey. Gail

MY wife worked for a company who has less then 50 employees and to cover this kind of benefits in the Ins plan you must pay extra for it. my wifes employee who is a gem of a boss paid the extra out of his pocket so my wife and another person could get by-pass surgery done and she close to losing 200 lbs. talk to your employer having a healthy employee would help in lone run. don't give up your find a way.

Maryland Code : INSURANCE : TITLE 15. HEALTH INSURANCE : SUBTITLE 8. REQUIRED HEALTH INSURANCE BENEFITS : § 15-839. Coverage for treatment of morbid obesity. § 15-839. Coverage for treatment of morbid obesity. (a) Definitions.- (1) In this section the following words have the meanings indicated. (2) "Body mass index" means a practical marker that is used to assess the degree of obesity and is calculated by dividing the weight in kilograms by the height in meters squared. (3) "Morbid obesity" means a body mass index that is: (i) greater than 40 kilograms per meter squared; or (ii) equal to or greater than 35 kilograms per meter squared with a comorbid medical condition, including hypertension, a cardiopulmonary condition, sleep apnea, or diabetes. (b) Applicability.- This section applies to: (1) insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies or contracts that are issued or delivered in the State; (2) health maintenance organizations that provide hospital, medical, or surgical benefits to individuals or groups under contracts that are issued or delivered in the State; and (3) managed care organizations, as defined in § 15-101 of the Health - General Article. (c) Coverage - In general.- An entity subject to this section shall provide coverage for the surgical treatment of morbid obesity that is: (1) recognized by the National Institutes of Health as effective for the long-term reversal of morbid obesity; and (2) consistent with guidelines approved by the National Institutes of Health. (d) Extent of coverage for other necessary surgical procedures.- An entity subject to this section shall provide the benefits required under this section to the same extent as for other medically necessary surgical procedures under the enrollee's or insured's contract or policy with the entity. [2001, chs. 493, 736; 2004, ch. 486; 2005, ch. 301.] Here is the web link http://198.187.128.12/maryland/lpext.dll?f=templates&fn=fs-main.htm&2.0 Hope this helps. The only reason I found this law is that I was completing my bachelor of science in paralegal studies and became very aquainted with the Maryland Code. Let me know if the link doens't work for you -- it should.