How to get surgery

[redagate 0]

I live six miles from Oregon border. Blue cross anthem requires surgery to be done in CA in Center of Excellence. All of them are over 180 miles from home. Closest center in Chico want $8500 in out of pocket expenses on top of insurance! Any suggestions? Who to contact that can help me?:thumbup:

[Devana 0]

Hi, welcome to LBT.

I don't know about this. Is is the distance, the $$ or both that are the problem?

I would suggest you check out the Oregon threads as well as the Mexico threads. It may be a couple thousand dollars cheaper to just get it done down there.

All the best!

[montynic 1]

I live six miles from Oregon border. Blue cross anthem requires surgery to be done in CA in Center of Excellence. All of them are over 180 miles from home. Closest center in Chico want $8500 in out of pocket expenses on top of insurance! Any suggestions? Who to contact that can help me?:ohmy:

As you know, all insurances are different. I learned at my initial informational session that doctors and Centers of Excellence charge a "program fee" (the $8,500 out of pocket you are facing) to patients with certain insurances. For example, I have Blue Shield PPO and was not required to pay a program fee. However, if I would have had Blue Cross, I would have been facing a program fee. Are you sure it has to be done in CA? There are Centers of Excellence in OR (I only know that because I have family in various parts of OR that have had surgery at Centers of Excellence). If your insurance requires surgery to be done at a Center of Excellence in CA, I would recommend calling around and finding the most inexpensive program fee. Since you are already having to drive all the way to Chico, have you looked into Sacramento? There are several Centers of Excellence to choose from in Sacramento and it is only an extra hour or so from Chico. If surgery has to be done in CA, what does that mean for your post-op appts and your fills? Will you have to come back to CA for those as well? Good luck!

[HappyMom 1]

I have Anthem BCBS of California. We live in NM and I wasn't required to travel to have my surgery. I was able to have the surgery at the local hospital in Albuquerque.

I agree with montynic that the different type of Anthem BCBS insurance makes a difference.....PPO vs HMO.

With my insurance (PPO) I only had to pay 10% up to our family annual out of pocket maximum. There was no program fees or anything else collected up-front for the surgery.

I would recommend speaking again with the insurance company and letting them know that the travel is too far for you and can they please change your surgery location to some facility closer. This may also get rid of the 'program fee' charged by the Center of Excellence (if you are a PPO and not HMO).

Good luck to you. I really hope that this all works out well and you can stay closer to home!