I have fep blue cross blue shield and I was wondering what my out of pocket expenses might be for the gastric sleeve surgery. Does any one out there have any idea?

I have Fep Blue (Basic) and my surgery was back in October, so here are my costs (approximations):

$25 (x5) DR visits for qualification, but would have had most anyways

$0 RD counseling

$0 Labs

$180 Stress Test ($75 + meds & supplies)

$200 EGD consultation fee

$150 EGD

$75 Pulmonary Function Test

$70 Surgeon office visits ($35 x 2)

$600 Emory Bariatric program fee (mandantory, includes group counseling’s for life)

$300 Emory Hospital charges ($150 per night)

$150 Surgeon fee (anesthesiologist covered by hospital)

Do you have Standard or Basic. I have FEP BC/BS as well. I have the Basic which I understand is much cheaper. I am just starting my process as well. Heather

I also have BC/BS and was wondering the same thing. My policy is that I pay 50% until I have met my deductible then they pay 100%. My deductible is $750 so I'm hoping it will cover most of the cost but I'm sure there will be something else that will be my responsibility. Good luck everyone.

I have basic fep BC/BS. the only thing is that i had standard last year when i started the process and this year i switched to basic. all my preop test, labs and exams were under my standard plan so i just payed the copay but my surgery was under my basic plan and i had to pay $150 per surgeon (i only had one) and $150 a day for the hospital stay (i stayed 2 days) so i payed $300 there. Total of $450 if you don't count the copays for dr's visits.

If you have standard, all you have to pay is your deductible.

hope this helps!

How long did it take for approval? My paperwork was filed last week. Just wondering how long to freak out waiting.

I have the standard option.

From one Fepblue to another.....consider switching next year to Basic. I paid for Standard for 14 years and last year I went to the insurance fair.....did my research and in my opinion Basic is better and cheaper. I had back surgery last year and ended up paying over 5000 out of pocket. With basic I would have paid much less. . Good luck. Keep us posted. I have my first appt this Th. Heather

This is what i was told by my doctors office.

Any out of pocket costs would be limited to your copay, deductible and coinsurance amounts, along with any annual out of pocket maximum limitations that may apply, as dictated by your plan. Attached is the benefit summary for Federal BCBS. General benefit information begins on page 31 and benefits for surgery begins on page 53.

Federal BCBS Benefit Plan Information: http://www.fepblue.org/benefitplans/2012-sbp/bcbs-2012-RI71-005.pdf

Any one else have fep blue cross blue shield?

Hello all. I work for BCBS. My recommendation would be to just contact the insurance company. Policies can differ, the representatives are there to help and answer your questions. If you didn't have questions we wouldn't have jobs! I know here in Kansas City our FEP department is so nice. I'm not sure about other Blues, but if you have any questions at all I would call to clarify. This journey has so many other factors and your insurance reps can help to make that part of the process easier to understand.

I got a final bill from the hospital for my surgery and it was $250.00. Now that does not include my doctors fees ($465.20) or anesthesia (?) but I was relieved.

my BCBS doesnt cover bariatric surgery AT ALL. I'm now self pay.

I have bcbs fed

I had to pay $5000 to the

Hospital and 180 to the doctor..... wth???..

On 3/29/2025 at 1:52 PM, Alialiali said:

I have bcbs fed

I had to pay $5000 to the

Hospital and 180 to the doctor..... wth???..

Call the insurance and make sure they charged you correctly. It may be correct, but if it sounds high for your insurance definitely call them sometimes they may even build the insurance and if it denies, they just send you the whole bill and don’t bother telling you it’s because the claim denied for some reason or part of the claim denied or whatever and they’re technically not allowed to bill you for the whole balance, but they do it very often and just play dumb or whatever and let you pay instead of them, fixing it and having the insurance pay

Especially if they didn’t get one of the authorizations. That happens very often where they will try to balance bill you and they’re not allowed to. Unless sometimes they can have you sign a piece of paper saying that you’ll pay even if the insurance doesn’t but if it’s really something that should’ve been covered and it’s just because they didn’t get authorization you can do a grievance with your insurance company. Because even if you sign that thing saying if your insurance didn’t pay that you would pay that’s not a free pass for them to not do their job properly and make you pay for it. It’s a shame we have to have a serious illness to learn all this stuff, but I’ve been learning a lot lately. And these doctors will rip you off. You should get a copy of the explanation of benefits or something similar from your insurance company and it will say how much you’re supposed to pay as long as you want to an network doctor and they accepted you as a patient then that’s an agreement between them and the insurance company to accept whatever they say you’re responsible for and so what your explanation of benefits says should be your responsibility unless you signed something stating otherwise. And if you did sign anything, it still doesn’t mean it’s a free pass for them to have not billed it properly. If the insurance company says that it was denied because of something they did wrong then you can file the grievance.