I GOT APPROVED!!!!!! Well almost

The peer to peer review was successful.  I got approved to have this demon band removed but was denied on having bypass because BCBS said I'd exceeded my 1 WLS. I paid out of pocket for the lap and in 2011. The bariatric coordinator plans to contact BCBS and tell them that. Hopefully they will correct that. If not my out of pokect fees for RNY will be $1900. I can possibly have surgery in a month. Im so excited. Hopefully BCBS will pay for the bypass. Im going to try, wish me luck!!!

Self pay for RNY can't possibly be $1,900. I would bet it was more like $25,000 or $30,000.

You may end up needing to file an appeal if they deny you again. More and more insurance companies are instituting a 1 WLS per lufetime limit, but I have no idea how this works if you were self pay initially.

Keep us posted. I'm interested in how you make out.

 My insurance company, Blue Cross Blue Shield, has the same policy. They would not pay for my RNY because I had a lap band several years ago. I ended up being a self-pay.  The cost is higher for a revision than for the basic RNY. I think my total cost was right at $23,000. Good luck!