I have blue cross blue shield Federal, Basic Option. Can anyone explain what out of pocket expenses are? It says mine are $5000. In the explanation of benefits it says I will pay $150 admission fee/surgeon fee & $150 per night I'm there (2 nights) we have no deductible with basic option so I'm curious how the out of pocket comes into play or does it? I was reading the explanation of benefits like I would only pay the $450 total.

I have blue cross blue shield Federal' date=' Basic Option. Can anyone explain what out of pocket expenses are? It says mine are 5000. In the explanation of benefits it says I will pay 150 admission fee/surgeon fee & 150 per night I'm there (2 nights) we have no deductible with basic option so I'm curious how the out of pocket comes into play or does it? I was reading the explanation of benefits like I would only pay the 450 total.[/quote']

Out of pocket example if your surgery is $30,000 & your insurance pays 90% then you only would owe $3,000plus your deductible of $450.

Ok...that makes sense!!! Thank u!

For Basic the MOST your family can pay out of pocket in a year is $5000. After that all medical bills are covered with NO copays, as long as you use preferred providers. So you have the surgery copay of 150.00 (don't quote me but I think that included the one night in the hospital) plus $150.00 for additional nights. My total for 3 nights in the hospital and all testing was under $1000.

So the $5K is for all covered? (It's me, my hubby & 1 child)

Yes, on the bottom of an EOB (Explanation of benefits) that you get every time they pay something there is a box that says summary of Out-of-pocket expenses for 2013. It shows for your family how much has been spent on copays. Our family is at 3319. once that hits 5000. all copays are covered until December 31.

wow...I'm going to dig one out now! Didnt know it was on there! Thank you SO much Chinamama!

No problem, hubby has been with the feds for 22 years in October and I have figured out one or two things...

Is it better to go with Standard? I have basic right now but November is coming up and I can change. Do you know the difference in coverage?