Out Of Pocket Costs

[New1 201]

According to my plan I'm supposed to have an out of pocket of 3k.

[sarahcc 184]

I have a PPO with no deductible, but BCBSIL is covering me at 90%. I'm guessing that won't matter however because I have an out of pocket max of $1800. Like others, co-pays do not count toward OOP max but I've only paid about $75 so far. I just got a bill for $265 which I'm guessing was my pre-admissions testing lab work or whatnot that isn't covered as an office visit. However, it's not due until after my surgery so I'm going to pay it all together and see what it comes out to. I'm pretty positive it will be well over 18K though, so I'm just going to assume my amount will be $1800 total...

[phatdivabbw 86]

I had $15 copays for my Pulmonary and Cardiology consult. I didn't have to pay for my psych consult, labwork, sleep study and doppler study. (I work for the hospital and making sure I do everything in network or at the hospital.) My deductible is $300. and the insurance company will pay 80%. All my hospital stuff is covered 100%. I hope the doctor bills me for the deductible but I guess I should make sure I have the $300 just in case. I'm hoping to get a date in two weeks after my endoscopy on the 18th.

[urbandecayno5 40]

I have empire bcbs ppo NY..they cover the surgery 100%. The only thing I have to pay are the co pays which is $30 for specialists and $20 for my regular pcp..so I spent $175-$200 for those visits and that's it

[RickM 1,747]

There are so many variables in how the policies are written that it's hard to judge based upon others' experiences. I have Aetna but when going into surgery we were already part way between having the deductible met and maxing the out of pocket expense. So, while most of the pre-op and hospital expenses were at our normal 20% copay, by the time they got around to paying the surgeon's fees, he was covered 100% even though he is out of network (we go for quality, irrespective what the insurance company says!)