Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BCBS Fed Basic - 30% Drug Charges?



Recommended Posts

For anyone that has already had surgery and you have BCBS Federal- Basic, did you have to pay for 30% of the drugs/agents (anesthetics) that were given to you during your surgery or the medications that were given to you while you were in the hospital?

I'm getting conflicting information. I was told by the insurance company that anesthesia is covered 100% but I'm responsible for 30% of the drugs or agents used during my surgery.

Thanks in advance for your feedback.

Share this post


Link to post
Share on other sites

Shirley here, retired from Veterans Affairs. I had a stroke 2011 for which the total bill was over $27,000. My cost was only a few hundred, mostly for specialists fees. I do not remember any specific charge for drugs used during surgery. In November 2012, I had a partial knee replacement. The bill was over $40,000 for which again I only paid a few hundred. In February this year, I had some spinal reconstruction, for over %80,000 and once AGAIN, I only paid a few hundred. BCBS Federal is the most awesome insurance coverage I have ever had. So even if your bill itself is some crazy number, your out of pocket shouldn't be so bad.

Share this post


Link to post
Share on other sites

Great question. I also have BCBS Federal and wanted to know how much I needed to pay out of pocket. I was told it was $150 for the surgeon, $150 per day in the hospital/facility, and 30% for the drugs. I have put several calls into the doc office but still have gotten no response. I will be out of work for two weeks, God willing, and do not want to use my leave. Any help on this is greatly appreciated

Share this post


Link to post
Share on other sites

I have BCBS federal (TN) and paid $300 for my surgery and hospital stay Period. And I was hospitalized for 2 days on 8/19. Just make sure that everyone you deal with (anesthesiologist, ect) are in the network. I was soo afraid I'd be hit with some sort of astronomical drug bill and I couldn't rest easy until I saw my EOB!

Share this post


Link to post
Share on other sites

I had surgery last year. It was $300. I was told by my insurance rep that it would be the same this time.

Share this post


Link to post
Share on other sites

Hello. I have Fed BC/BS basic. I paid $150 to the physician and $150 to the hospital. I did not pay anything else out of pocket. Just be sure (as stated above) that your Dr and hospital are in the network. It is wonderful insurance:)

Share this post


Link to post
Share on other sites

Thanks everyone!! I've already confirmed that the surgeon, hospital, anesthesiologist, and everyone else involved are preferred providers.

Again, thanks so much for your input!

Share this post


Link to post
Share on other sites

Just to follow up, I finally got BCBS, in writing, to confirm that there is no 30% charge for drugs/agents for inpatient care. I hope this helps. They said:

"for covered 2013 inpatient stays you would be liable for the $150 per day, $750 maximum co-payment for the hospital, that includes anesthesia, supplies and equipment; you have no liability for doctor's visits while you are an inpatient at the hospital, but you are liable for a $150 co-payment for each surgeon which is a separate liability. The 30% co-insurance usually applies to outpatient services, at a doctor's office or outpatient facility."

Share this post


Link to post
Share on other sites

Thanks! How do you find out if everything is in network? Do you wait for the hospital insurance people to call you before the surgery?

Share this post


Link to post
Share on other sites

Try going to www.fepblue.org. In the toolbar across the top of the homepage, their is a category called Service Providers. I guess you could start there. Keep in mind that I am in Chicago. You need to find what is available in your own local....but this is a federal site, so you should just be able to type it in.

Share this post


Link to post
Share on other sites

I ask the provider and then sometime call the 1-800 to double check. Can you tell I've been burned once or twice

Share this post


Link to post
Share on other sites

Just to follow up, I finally got BCBS, in writing, to confirm that there is no 30% charge for drugs/agents for inpatient care. I hope this helps. They said:

"for covered 2013 inpatient stays you would be liable for the $150 per day, $750 maximum co-payment for the hospital, that includes anesthesia, supplies and equipment; you have no liability for doctor's visits while you are an inpatient at the hospital, but you are liable for a $150 co-payment for each surgeon which is a separate liability. The 30% co-insurance usually applies to outpatient services, at a doctor's office or outpatient facility."

awesome! Thanks! Im going with the RNY surgery instead of sleeve ive decided.

Share this post


Link to post
Share on other sites

Here is a question and obviously I am going to call BCBS but the labs we have to get preop, the doc staff told me to go to Quest. Did u pay for the labs to be done?

Share this post


Link to post
Share on other sites

Here is a question and obviously I am going to call BCBS but the labs we have to get preop' date=' the doc staff told me to go to Quest. Did u pay for the labs to be done? [/quote']

I didn't pay anything for labs.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×