StephOinAZ

On a dark and stormy night, wait...no...it was a bright and sunny 118 degree Arizona day...I was looking up information on Clomid because DH and I had given up trying to get pregnant naturally. We honestly haven't been trying as long as some, but to me 3 years is long enough. Any time I brought up the idea of Clomid to my OB/GYN she told me I needed to loose some weight before she'd agree to put me on it. She never told me how much, I never thought about asking. Well, after loosing only 10lbs after an entire year (thanks a lot insuline resistance), I felt that I deserved to be put on Clomid anyway since I made a huge effort. It's the thought that counts, right? So for the millionth time, I was lost in some web of threads looking up info, tips, success stories, etc on Clomid when I happened to see a thread with a topic I've never see before. The user was asking if anyone knew the exact BMI one would have to be in order to be approved for Clomid. Huh? You had to be a certain BMI? I opened up the post and saw dozens of replies, each of them from women all over the country, all of whom stated that the maximum BMI that you can be to be approved for Clomid is 30. THIRTY!!!!!!!!!!!!!! I currently weigh 345 with a BMI of 54. It took me ONE YEAR to loose 10 lbs and now I have to loose 120 before I'll even be CONSIDERED for Clomid?!?!?! At the rate I'm going that could take me 12 years!! Has anyone else heard of this rule? I mean this whole time my Dr. was telling me to loose weight I was expecting that she wanted me to loose like 20 or 30 lbs, not 120! So as I resolved myself into a pool of tears, I saw a little square flashing at me on the side of the message board screen with an add for Lap-Band. I opened it and now here I am. I'm just starting down this road and I have a LONG way to go, but I'm here. And that's a huge start.

Hi Chris :cry_smile: I'm Stephanie and I'm new here too. I completely understand how you feel. Let me know if you ever want to talk or get some of the jitters off your chest! I'm right there with ya buddy :drool: You can find TONS of support here, no doubt!

Well some offices will be more helpful then others, doesn't sound like yours wanted to be right now. Here are some universal codes for bariatric surgery (generalized, not specific for Lap-Band but if they cover bariatric surgery then you can most likely try for lap-band) : These are from other bandsters: 43843 43770 These are from my BC/BS handbook w/the surgery requirements and these are specific for Lap-Band: 43773 43774 43843 43886 43887 43888 HCPCS 52082 HCPCS 52083 I know it may seem like a lot but hopefully your insurance will cover ONE of those codes, if not more. Insurance really is a pain. I see why so many people are willing to self pay, lol. Hope this helps!

Thanks for the tips :cool2: That is all wonderful information for newbies like me who need re-assurance.

Hi! Looks like I'm a little late posting :thumbup: But I'm 23, I live way down in Coolidge, but I would still love to meet new friends! I'm not banded yet, still working on it. :cool2:

I also have BC/BS PPO, but the package that my employer selected covers weight loss surgery. One tip is to not ask directly if the cover lap-bad, but ask if the cover "surgery for the treatment of morbid obesity" or better yet, call the surgeon that you want to have your surgery done through, and ask their biller what insurance code they use for lap-band and then call BC/BS and just ask if they cover that exact code. Give them as little personal information as you can. They can tell you if you just give them the group number and the company name. You don't need to give them anything else, I didn't since I didn't have any other information. Try to find out if it's just your employer that excluded that option from the insurance pacakge, or if it's BC/BS just not approving it. Insurance companies are very known for denying claims multiple times before they approve them, just to see who's seriouse or not. I really wish you the best of luck! Feel free to send me a message :cool2:

I'm not sure how COBRA works, but I completely agree, if you worked enough hours to have the sick time and/or vacation time, then that can't count against you! Did they take your insurance payments out of your paycheck? If so, then legally they cannot deny you coverage since you paid for it. It does sound pretty shady. That is very frusterating, I'm sorry you're going through that. Don't give up and make sure you keep fighting for this! Good luck!!

Oh wow, that's coming up fast! Thanks for the reply, I really appreciate it. Good luck!!

Thanks for the replies! I really appreciate it :smile: I really want to loose weight first, before I get pregnant. My hope is that I am banded within a few months and then wait at least a year before we start trying. I'd really love to just get prego naturally w/o Clomid but I'm willing to do whatever I need to do. Thanks again!! :wub:

Hi Emily :biggrin: I also have PCOS and a long family history of seriouse health problems on both sides of my family. I'm still in the pre-approval stage myself, it's a slow process. I'm so excited at the thought of Lap-Band just based on all the stories I've heard from other bandsters who also have PCOS and how much of a difference it made! PCOS makes lossing weight SO much harder! I work out all the time and eat right and I never loose weight. My doctor just keeps saying that because of my insuline resistance that it will be very hard for me to loose weight w/o some kind of "assistance." That's exactly why I'm getting the band! So I'm at the starting gates of this journey also so if you need a buddy to go through it with you, I'm here :biggrin2:

Hi everyone :crying: My name is Stephanie, I'm 23 (ugh...) and I live in AZ :tt2: ok cheesy intro aside, I'm new to the idea of WLS and I'm super excited but a little scared too. My DH just got a new job so our insurance won't even kick in until October BUT I called the insurance co we WILL have (BCBS-ppo) and gave them my hubby's emplorer's group # and they confirmed that WLS is covered!!! YAY!!!! Right now I'm just trying to figure out who the best surgeon to go see is. Any recomendations? I work from home and have very few friends here in AZ since this is not where I grew up and I don't get out much, so I could really use some pals to go through this with me Good luck to you all!!!

Wow I'm the first one from Arizona to reply to this I'm in Coolidge, AZ!

Hi all :crying: I'm new here and I swear I've gone through about a million pages of threads looking for this information. I'm trying to find out if anyone with BCBS of ARIZONA (PPO) got approved or denied? I want to know :wink2: Good, bad, or whatever! Thanks so much!!!:thumbup: