AspieMom 13 Posted January 27, 2013 So our ins is bcbs of il - they say they cover half after deductible is met. Well we are going through that deductible pretty quickly this year. So has anyone had this pay half for ins? If so what were the amts like? All the administrator at the seminar could tell me was it wasn't half of the cash price (which is $12000) - different amt all together. So I have no clue price wise what I am getting into. Just curious if I am getting my hopes up too much and we won't be able to afford it.... I am in the process of getting all my records and paperwork in to get my first appt. just hate the idea of getting my hopes up and submitting everything to find out we can't afford it Share this post Link to post Share on other sites
Sadtosaygoodbye 256 Posted January 27, 2013 I have anthem BCBS through my husbands employer. After my deductible of $300 I pay 20% of the negotiated rate for the surgery (co-insurance) until I reach my maximum out of pocket which is $2,000 dollars. after I have reached $2,000 BCBS covers all covered costs at 100%. I would call your plan provider in the AM to ask what is your deductible, out of pocket maximum, and co-insurance amount. This will better help you understand and get an estimate of your costs per calendar year. Share this post Link to post Share on other sites
cmaloney 151 Posted January 27, 2013 I have BCBS of IL also & they covered the whole thing. Thankfully I also didn't have to wait 6 months. I got it done in 4. Because pre- sleeve I was already working with a NUT., for 2 years prior, they were able to use his notes. That saved alot of time. Share this post Link to post Share on other sites
sramos89 260 Posted January 27, 2013 I have BCBS IL and I didn't have that, it was paid for like normal after deductable. It may be something the employer has dictated. I know employers can put different "riders" so to speak on this surgery. I didn't have any. 1 Sadtosaygoodbye reacted to this Share this post Link to post Share on other sites
AspieMom 13 Posted January 27, 2013 Thanks guys that must be it. Hubby works at sprint and they probably added it . Does anyone mind me asking what their 20% of the bill was? Share this post Link to post Share on other sites
cmaloney 151 Posted January 28, 2013 I'm really not sure. I just got a bill for $190.00 that I'm going to put towards my husbands insurance - Cigna & see what happens. If it kicks back then I'll pay it. I believe my surgery was $15,000. Share this post Link to post Share on other sites
AspieMom 13 Posted February 19, 2013 Just in case anyone else gets this insurance and has questions . It's half of the actual procedure which comes out to 2000-3000 out of pocket ( if we have already hit our deductible which we are working in lol). Everything else is covered as normal 80/20. Share this post Link to post Share on other sites
tamarlarae 11 Posted March 21, 2013 AspieMom- I am looking into getting this surgery and have BCBS of IL but I live in AZ. I am the only one on my insurance so I KNOW I have met the $250 deductible. I have called 4 times and each time gotten a different answer. SOOO frustrating. My husband and I live paycheck to paycheck but I have student loan money I plan on using for this surgery as well as (hopefully) some of our tax return money. Did you have to pay $2500-$3000 and then more? Share this post Link to post Share on other sites
AspieMom 13 Posted March 22, 2013 I believe it will be around $2500. But I go for my first appt next Tuesday. I have just talked to my coordinator and the insurance co. Of course my hubby's work makes it different than they were used to. The insurance agent I talked to said she had never seen a rider like it on their insurance so she had to pull it all out, read it, and get back to me later. Share this post Link to post Share on other sites
tamarlarae 11 Posted March 22, 2013 Ok great thank you!! I have my first appointment with the surgeon on the 29th (next Friday eeek!) So I am sure I will know more then. Most posts I read, people have a very easy time dealing with them. However, I only have a high BMI and no other co morbidies so here's to hoping I get approved!! Share this post Link to post Share on other sites