Copayment For Bcbs Federal-Basic

[TinaMari 75]

Hi Everyone,

I'm scheduled for surgery on the 17th and noone has called me to tell me the exact figures that I have to come out of pocket the day of. I just got off the phone with the hosipital and they claim that someone will call me 1 day prior to my surgery date to give me an exact total. Really!!!? How the hell is that enough time!? I'm so concerned because I don't want to get to the hospital and they tell me my co-pay is like $1500 or something. I don't have any kind of money laying around. I called BCBS and they told me it depends on how the doctor/hospital codes the procedure. I know I have a $150 co-pay per performing surgeon plus $75/day if it's coded as outpatient and 30% of the allowance for drugs... At least that's what the representative of BCBS told me. But WTH does that add up too!!? I need to know exact figures or at least a close estimate so that I'm not financially strapped for the rest of the month. UGH! Does anyone with BCBS Fed-Basic remember how much their co-pay was?

Thanks for your help!

[titania2875 4]

_{I have bcbs federal basic and my copayment for the hospital was 150.00 i was only in the hospital one day so the copayment covered it. but be careful i just received a bill for 7999.00 from someone that assisted in the OR that is apparently not in my network and I am giving this bill to my surgeon tomorrow when I go for my 7 week exam stating that I did not authorize anybody in the OR that was not covered by insurance considering I switched surgeons because the one I initally wanted was not in my network. I am sure the office will take care of it with insurance company and make sure that it is coded differently when it is rebilled to bcbs.}

[TinaMari 75]

OMG! That's awful. I hope that does not happen to me. I just got off the phone with the hospital for the stupid pre-interview questionnaire and the lady tells me that the anesthesiologist wants a letter from the PCP stating she is aware of my surgery!!!? WTF!!!? First off, why would you tell me this 8 days before the surgery is scheduled. Secondly, WTH is the anesthesiologist to be demanding clearance letters!!? Like really? My insurance didn't require that nor did the surgeon so why is he. I am super livid! This is ass backwards .

[soccermomx2 111]

I have BCBS FED Standard. They can't really give you an exact amount but you would be billed not pay at the hospital. Also with mine the pay 85% until you reach you max (mine is $5000).

I actually went in to have lap band done on 5/29....they couldn't do it because of an blood vessel. Total cost for sx was $29000... That was both surgeon and anesthesiology, actual surgery and pre-op testing. I paid $230 total out of pocket. My dr office tells patients max $1000 usual total out of pocket.

So for my upcoming VSG...it will be completely covered. Also VSG is cheaper than lap band. You can also do a payment plan with hospital for any out of pocket charges.

Wishing you best of luck...also totally agree to double check if everyone that will be in OR is preferred provider before surgery. You money ... Your choice.

[NDN_RN 527]

Out of pocket costs for this is actually less with Basic than with standard. The reasoning is with standard you can actually go out of network, as with Basic, you can't. The cost for the surgery is 150 dollars for the surgeon, all other costas ar covered. The cost for the hospital stay is 150 a night, with a 750 dollar maximum. With standard, you pay a flat 250 for the hospital stay, but you have to pay 15% of the "usual and customary reimbursement" for each doctor involved in the surgery (surgeon, anesthesiologist, radiologist, blablabla) and the surgical costs. That ends up being way more out of pocket than Basic. Fepblue.org has a good comparison tool