Out Of Pocket Costs With Blue Cross Blue Shield Of Illinois

[Michelle Wolfe 9]

Just curious what other people have had to pay. I was under the impression I had a $200 deductible and the rest was covered but so far they are saying I owe $330 and they arent done processing...

[5DogMa 62]

Read your policy. Most insurance has a deductable which is your $200 and then play a certain percent of "reasonable and customary charges" of covered expenses. Ask what your max out of pocket is per year and know that's probably how much you'll end up paying. MIne was $3,000.

[WhoozisAnyway 176]

I have BCBSIL with a $300 deductible and $1000 OOP.

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[IowaAndy 95]

I had a $500 deductible and then the insurance paid 80/20 until I had paid another $1000 out of pocket. So my lapband cost me $1500 total and the insurance paid the rest. Of course I still had to pay all of my office visit copays presurgery for the surgeon, physical, cardiologist, shrink etc. After your surgery you will have a global period with your surgeon. This will cover all associated office visits to him for usually around 90 days. Then you will be back to paying office copays.

[Felicity549 47]

I was wondering this, too. I also have BCBS IL. My deductible is $500 and max out of pocket per year is $2,500. I'm wondering if I'll pay these amounts up front or be billed after. I'm assuming the $500 will be due mostly up front but curious about the rest.

[5DogMa 62]

You are correct the first $500 you will end up paying after the first few visits, but it does go thru your insurance first because the doctor or facility might charge $500 for an office visit but the insurance gets a discount off that. So maybe after the insurance discount the bill is now $250. If you haven't paid your deductable yet you would owe the doctor or faciity the $250. This goes on until you reach and paid your deductable of $500. After you have paid your deducable when the insurance is billed they will take their discount and you will pay the difference of what they paid and the discounted amount. So say the bill is $500 they take their 50% discount so the bill is now $250, your insurance paid 80% or $200 and you owe the rest which is the 20% or $50. Now once you've paid all those 20% amounts that reach your max out of pocket $2,500 or whatever that is then your insurance will start paying 100%. They always take their discount of course. Bottom line is you'll end up paying only the total out of pocket which for you looks like $2,500. Pretty good deal huh?

Even if you have BCBSIL doesn't mean you'll have the same coverage as someone else who has BCBSIL. It's your employeer who chooses the policy and coverage and every employeer is different. I have BCBSLA and there were some hoopes to jump through to get approved for WLS and you had to meet certain requirements. Some have to wait 6 months others don't. It's best to call you insurance company and go over all of this to make sure you know what is expected of you and what the total costs will be for you.

[Michelle Wolfe 9]

Yeah, I guess I should have asked if anyone has used bcbsil with Boeing for wls.