CareFirst Exclusion and Self-Pay Patients

Hello, I live in Maryland where it is state law that WLS is covered by insurance. There is one loophole in that law. Small Group Plans can have the procedure excluded from the list of approved surgeries if they wish. Of course, I have a small group plan. I've spoken with a lawyer who has experience with this type of plan in Maryland. He has said that he has never heard of a denial being approved in this situation. Since that is the case, I'm going to finance this on my own. Not 100% sure how I'm coming up with $25,000, but I have faith that it will all work out. I'm hoping for feedback or answers or something on two questions.... 1) Anyone else fight an insurance company that had it excluded from the policy and WIN the fight? Part of me wants to keep fighting, even though my surgery is set for 8/30. The thought being that if they approve it after the fact, I'll get the money back. Or if I can make it easier for someone else, then that'll be worth it for me. 2) Got any creative ways to finance this? I applied for a loan with my credit union and was denied. REALLY not happy about this. I don't want to have to ask for help from my family members, but that might be my only option. (And I like my surgeon, so choosing another one isn't an option). Thanks!! - Nancy

Contact Gary and ask him what he thinks. http://www.obesitylawyers.com/ Donna 338/195

Actually, I did. Though I spoke with his partner (via email). He said that he's never heard of a case like mine being approved for surgery. So that's why I have to go the self-pay route. Thanks though! - Nancy