Whats the deal with BC/BS of NM?

Hi all!!! I was wondering if anyone has had the same troubles I've been having. I called BC/BS nm months back and was told that they would nolonger be covering any WLS surgery past the new year. Those people who had surgery dates past the new year would still be able to get it done if they were preapproved before the new year. Any info would be greatly appreciated.! thanks karen

Can't help much, but I do know that BS/BC Federal employee program is still covering WLS, I have a friend from NM that switched from Presbyterian Health to BS/BC Federal and is having the surgery with Dr. Blackstone in Scottsdale AZ.

Well I checked out an old policy I found in the back of my file cabinet. It explained that "Weight reduction programs for general well-being was an example of NON-reimbursable Health care expense". This surgery shouldnt fall under general well-being, so maybe there is a little flicker of a light at the end of the tunnel. I think I'm going to see what my Dr. and surgeon can get done together. I checked my Policy and it is BC/BS PPO of NM. I think the best thing to do for everyone is not to stall on this at all, who knows how long that any ins. will cover the surgery. If I had gotten serious about this I could've had a less evasive surgery years ago. I gradually lose weight every year and then put more back on. Same ol' same ol'. If this insurance doesn't work out I will find another way.

Yes Karen- I too have BCBS of NM and they have a written exclusion policy. I am going to save pay and not very happy about it. Best Wishes. Valerie

Sorry about not getting back sooner. I've been stuck over in Dudleyville AZ for the past week. I felt like I was in that movie Wrong Turn. I've been talking with my doctor here in Arizona and he said that they can not deny me. He feels really strong about me having the surgery. Maybe if you could get your doctor to be more persuasive it could help. I really think my doctor and surgeon combined together are going to come through for me. karen

Hello all, I also have bc/bs of nm. i was denied for wls. I am appealing it. Both, my doctor and surgeon, and I are submitting letters. My phycoligist has already done so. I am worried that I will be denied again. could use some encouragement. Has someone out there been denied and then approved? Thanks. Maria