BCBSTX.... Co-Pay

[ladyperro2 10]

I'm insured by BCBSTX. They are very WLS friendly so I feel confident about getting approved but I was informed that I have a $5,000 co-pay. Does anyone know how this works? Will I have to pay the entire amount upfront if not, what does a payment plan consist of. I'm meeting with 3 docs here in the Houston area (Dr. Dexter Turquest, Dr. Robert Marvin, and Dr. Felix Spiegel) if any one has gone through this process and could give some info that would be great!

[slvarltx 332]

My co pay through BSBS of MI was paid to the hospital the week before my surgery.

[ladyperro2 10]

Okay, thanks. My insurance company told me that there is a $5000 co pay for All bariatric surgeries that would have to be paid first, then they would cover everything after that 100%. I have a co worker who had the lap band and she only paid around $1300 out of pocket and that included money given to the surgeon, anesthesiologist and hospital stay. So I'm curious to know if the amount paid out of pocket varies depending on what doctor performs the surgery.

[iwant2becurvynotlumpy 1]

Is that you specific plans deductible? I have BCBSTX as well. I have a $2000 deductible. I've met my deductible so now the actual surgery part is a little over $800 that I have to pay.

[ladyperro2 10]

@iwant2becurvynotlumpy. Yes it is for any bariatric procedure but i also have an annual $350 deductible. See the info below that i pulled from the website. I'm a little confused.

What is the overall deductible?

In-Network $350 Individual/$1,050 Family Out-of-Network $750 Individual/$2,250 Family Doesn’t apply to services that charge a copay, prescription drugs, and In-Network preventive care and diagnostic tests. Co-pays do not count toward the deductible

Are there other deductibles for specific services?

Yes. Bariatric surgery deductible $5,000/person. In- and Out-of-Network Prescription deductible $100/person. There are no other specific deductibles.

[iwant2becurvynotlumpy 1]

@iwant2becurvynotlumpy. Yes it is for any bariatric procedure but i also have an annual $350 deductible. See the info below that i pulled from the website. I'm a little confused.

What is the overall deductible?

In-Network $350 Individual/$1,050 Family Out-of-Network $750 Individual/$2,250 Family Doesn’t apply to services that charge a copay, prescription drugs, and In-Network preventive care and diagnostic tests. Co-pays do not count toward the deductible

Are there other deductibles for specific services?

Yes. Bariatric surgery deductible $5,000/person. In- and Out-of-Network Prescription deductible $100/person. There are no other specific deductibles.

Oh wow. What plan do you have?

[ladyperro2 10]

@@iwant2becurvynotlumpy

The University of Texas System: PPO Plan

My co-worker really didn't want to go in depth about the financial part. Which i totally understand and after speaking with the insurance rep i was still lost. My 1st appt is Wed so im hoping that the doc can give me some clarity.

[Brandy Wine 24]

I have bcbstx through my husband job. I've met my deductible and out of pocket. They paid 100%. Had my procedure Monday.

[ladyperro2 10]

@@Brandy Wine. That's awesome, Congratulations and best of luck!!!

[Brandy Wine 24]

Thank you @@ladyperro2