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BCBS of il - covers half?



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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 :(

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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.

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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.

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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.

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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?

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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.

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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.

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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?

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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.

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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!!

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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.
      · 0 replies
      1. This update has no replies.
    • 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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