Federal BCBS and Fills

[ReJoyce 1]

I see that some insurances differ on getting Fills. I have tried to get a little info on this, but am still lost. Does the insurance cover fills and are they considered surgery? I have noticed this year that every time the doctor punctures you it is listed as a surgical procedure and I then have to pay $150. (example, everytime the podiatrist made the slightest cut on my sons toe [ingrown nail], I have to pay $150. Needless to say, I am now on a payment plan..ugh!)

[TracieR 88]

I have FEP BCBS Standard. On my EOB's fills are listed as a Surgery. My Dr. does not require a copay though. My doctor charges something $200 for a fill if you are a cash patient and my insurance pays something like $2000 per fill. CRAZY! I think that is why no copay - he is getting a fortune from the insurance company! What a racket!

[Grider 92]

I have FEP BCBS Standard. On my EOB's fills are listed as a Surgery. My Dr. does not require a copay though. My doctor charges something $200 for a fill if you are a cash patient and my insurance pays something like $2000 per fill. CRAZY! I think that is why no copay - he is getting a fortune from the insurance company! What a racket!

[Grider 92]

I have fepblue basic and not banded yet, have one more test- before can send in paperwork but I thought the co-pays were required by insurance? and my test is $75 copay, how is fills so much? I think Ill be asking that on the next call to FEPBLUE

[TracieR 88]

I have fepblue basic and not banded yet, have one more test- before can send in paperwork but I thought the co-pays were required by insurance? and my test is $75 copay, how is fills so much? I think Ill be asking that on the next call to FEPBLUE

I have no idea. My doctor made you sign a paper before surgery saying if your insurance does not cover your fill you will be charged $200-$250 (can't remember exactly). Well I have never been asked for a copay and when I receive my EOB it shows as Surgery and that the doctor receive $2000. Not sure how that works....glad that I don't have to pay though.

[MelindaH 3]

I have no idea. My doctor made you sign a paper before surgery saying if your insurance does not cover your fill you will be charged $200-$250 (can't remember exactly). Well I have never been asked for a copay and when I receive my EOB it shows as Surgery and that the doctor receive $2000. Not sure how that works....glad that I don't have to pay though.

That seems really over the top to me and I would report it to BCBS. I am thinking the cost for a fill averages about 250-$350 nationwide. It shouldn't matter if you have basic or standard....the charges should be the same, as is you should charge the same to pts with or without insurances. Please check this out.

Melinda

[TracieR 88]

That seems really over the top to me and I would report it to BCBS. I am thinking the cost for a fill averages about 250-$350 nationwide. It shouldn't matter if you have basic or standard....the charges should be the same, as is you should charge the same to pts with or without insurances. Please check this out.

Melinda

I don't think it matters basic or standard - I was just stating what I have. I will ask at my next appointment as well as follow up with BCBS.

[MelindaH 3]

I don't think it matters basic or standard - I was just stating what I have. I will ask at my next appointment as well as follow up with BCBS.

Thanks, I would be interested in what they say. Having billed insurance recently, this bothers me. We billed everybody, ins or no, the same charge. The reimbursement and co-pay is the patient's responsibility.

I reported a pharmacy scam this summer on new drug I was prescribed. It was all together in one box and was being distributed as a new brand, just for the packaging, and I was charged over $100 for my copay alone. I realized that every drug that was a part of this was generic and could be bought separtately at a much cheaper price. They thanked me and said I was correct and appreciated my honesty.

Melinda