SarahMarie83

I've been to 3 dif doctors and none of them would help me. I think they just my weight as an excuse because they don't know what the problem is. All my tests come back fine and they say I'm ovulating. I've been using the Clear Blue Easy Fertility Monitor for 2 years and monthly test kits before that. They never say I'm ovulating but the doctor insists I am. I've been on Metformin for awhile and taken several cylces of clomid and follistim injections. Nothing. My husband had his tests done and he's supposedly fine too but clearly something isn't. And I have checked into Carle's Reproductive center but my insurance won't cover them and they only do the IVF in Indianapolis. I appreciate the encouragement but I lost any semblance of hope a long time ago.

Lori, thanks for the info and I have considered going to a RE but I can't find any in the area. I live in a tiny town of 1300 that's 45 minutes from Champaign. The closest I could find is Indianapolis and I just don't have the time to drive 2 1/2 hours there and another 2 1/2 hours back, possibly multiple times a week. I couldn't possibly get that kind of time off work. According to my gynecologist, there's absolutely nothing wrong with me- I'm just too fat to get pregnant. It's so frustrating and this is my last resort. And the depression brought on by every doctor that I've been to telling me that it's all my fault for being so fat makes it all so much worse. I can barely get out of bed at this point and cry every time I see someone else pregnant. I don't know how much more I can take. I feel like I have so few options because I'm geographically restricted and don't have the time or resources to change that. *sigh*

Hello everyone, I'm new here and just starting the procedure. I'm in the Champaign area and also planning on using Dr. Rohrscheib. I'm trying to get my first appointment scheduled. He was recommended to me by my gynecologist, Dr. Suzanne Trupin after failed infertility treatment. Does anyone know how much of the process can be done in the Champaign office and how many appointments are usually required pre-surgery? Any info about the process w/ Dr. Rohrscheib would really be appreciated. Thanks!

Hello, I work for BCBS here in IL and have some advice for you. About the pre-existing clause - if you had insurance coverage prior to your current plan then you may be able to get that waived. Call your insurance carrier and find out if that's a possibility for you. Also find out if your BMI has to be 40+ for the entire 3 years or just at time of surgery. Ask if you can look up the Medical Policy used to deny you online or if they will provide you something in writing so you and your doctor have a finite list of exactly what you need. If all else fails, there's always the appeals process and they are generally reviewed outside of the strict policy based on true medical necessity. Don't give up hope just yet! Call your insurance company and find someone who is willing to take the time to help you and get the answers that you need. If you can afford it, by all means go with self pay....but very few of us are that position so I would recommend doing all you can to get it covered under your insurance. Hope this helps!

Hello, I work for an insurance company(BCBS IL actually) and see these quite often. I would recommend calling you insurance company and asking exactly what they're looking for. Also, if you go to the Provider section of their website you can probably find the Medical Policy that they're referencing and you can provide that to your surgeon to let them know in detail what is required. If they still deny your surgery after they get the info requested then ask how to appeal the decision. The reason these surgeries get denied so often is because the insurance company has a strict policy that they're adhering to but if it's truly medically necessary for your health and if you stick with it, you can most likely get that approval. The letter you posted doesn't say that you DIDN'T meet any requirements, just that something was missing so I would say your chances are good. As for the two reasons listed, it looks like the first part that says "Not a medical necessity' is just the standard verbage meaning that all requirements not met. It is the second paragraph that gives you the info you need on what was missing. Good luck to you and if you need any help with insurance lingo, let me know and I'll help you decipher things. Sarah