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Blue Shield of CA



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I'm on a crazy posting spree lately! :mellow: I have an *** with Blue Shield of CA and I was wondering if anyone else has this insurance? I'm not able to really get a price estimate until my pre-op consultation and I'm antsy to know what kind of money I'm looking at. I'm thinking most if not all will be covered since they had me to a 6 month program and meet with dieticians and psychiatrists etc...

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H .... M.... O * why did the site out asterisks on that????

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I have blue shield of ca and they told me about $6k due to my share of cost copay. But I have been paying into it with othe dr visits on my kids. So I may only need to pay like $5k. My co pay on office visits are $40. We may have different plans. I suggest u call them and ask.

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I have blue shield of ca and they told me about $6k due to my share of cost copay. But I have been paying into it with othe dr visits on my kids. So I may only need to pay like $5k. My co pay on office visits are $40. We may have different plans. I suggest u call them and ask.

OMG, I hope so.. I don't have $6,000..... not anywhere close to it and my Care Credit limit is barely $2k... I have 3 appointments next week with my surgeons office. I'm going to ask them and I PRAY that it's covered or less than 1k out of pocket. :unsure:

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I had the H M O of BCBS Access Plus in California, is that the same one? Mine was just co-pays all the way through. the biggest being the hospital co-pay of $150 per day (one day). This was 5 years ago.

And I stayed within my H M O network. That can make a HUGE difference.

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I had the H M O of BCBS Access Plus in California, is that the same one? Mine was just co-pays all the way through. the biggest being the hospital co-pay of $150 per day (one day). This was 5 years ago.

And I stayed within my H M O network. That can make a HUGE difference.

Mine's Blue Shield of CA which from my understanding is not affiliated with Blue Cross Blue Shield. I have an H M O and a specific Medical Group(Mercy) and everything I've done has been with Mercy contracted doctors, psychiatrists, nutritionists, & physical therapists. I've had a $40 co-pay for almost all visits.... I did try calling the insurance company but none of the reps seemed to give me the info I need. I feel more comfortable speaking to my surgeon about costs/financing so I'm going to ask on Tuesday.

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I work for BCBS if Illibois. We do a lot of calling to other states and you are right, Blue Shield and Blue Cross of Cali is different than BCBS, they are actually pretty much like 2 different companies. I am a customer advocate but I handle PPO accounts. We have ways of getting pricing as long as we have the right info, not sure why they couldn't do that with an ***. I would call them back and if you have to, ask to speak with a supervisor

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I work for BCBS if Illibois. We do a lot of calling to other states and you are right, Blue Shield and Blue Cross of Cali is different than BCBS, they are actually pretty much like 2 different companies. I am a customer advocate but I handle PPO accounts. We have ways of getting pricing as long as we have the right info, not sure why they couldn't do that with an ***. I would call them back and if you have to, ask to speak with a supervisor

Good idea, I will try that! The surgeons office called me and said they received prior authorization for surgery, but they didn't mention one thing about costs. I've seen the surgeon 3 times now. I kind of thought they would have mentioned it"(additional out of pocket) by now to prepare me.

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Yeah my surgeon gave me an estimate on what to expect in terms of coverage the day I went in for me 2 week pre op appointment. I honestly don't know much about ***'s but with a PPO you have an out of pocket maximum and with all the health issues and tests I have had done this year mine was met. I had 100% coverage for mine and I just saw the claims and one was 28,000 for the surgery center/surgeon and the other was 2500.00 for the anesthesia.

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Haha it got me on the H M O too lol

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Funny..... The hospital called me shortly after I posted this. They said according to my insurance and benefits I'm looking about $2500. My job has a program that pays 20% of any out of pocket so that's about $500

Not so bad I guess....$2000. Looks like I'm applying for another credit card tonight lol.

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Mine's Blue Shield of CA which from my understanding is not affiliated with Blue Cross Blue Shield. I have an H M O and a specific Medical Group(Mercy) and everything I've done has been with Mercy contracted doctors, psychiatrists, nutritionists, & physical therapists. I've had a $40 co-pay for almost all visits.... I did try calling the insurance company but none of the reps seemed to give me the info I need. I feel more comfortable speaking to my surgeon about costs/financing so I'm going to ask on Tuesday.

I am a little late replying to this, and I see you heard from the hospital. But you should be able to check online for what your hospital benefits are. Check your insurance card for the website. I know we don't have the same company, but you should be able to look it up, just to verify what the hospital told you was true. I didn't know I had a hospital co-pay (oops, my research was flawed), but when I looked at my plan..yes I sure did.

You might also be able to find your plan brochure online.

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I am a little late replying to this' date=' and I see you heard from the hospital. But you should be able to check online for what your hospital benefits are. Check your insurance card for the website. I know we don't have the same company, but you should be able to look it up, just to verify what the hospital told you was true. I didn't know I had a hospital co-pay (oops, my research was flawed), but when I looked at my plan..yes I sure did.

You might also be able to find your plan brochure online.[/quote']

Thanks. I have no hospital co pay. The only reason I have to pay at all is because I didn't meet my 3,000 deductible this year.

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My out of pocket with BCBS TX was 2' date='100.00[/quote']

Really? I am trying to find an insurance that will cover me my BMI is 35 did they give you any issues? Maybe BCBS of Texas is the answer I live in DFW

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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