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ANTHEM BLUE CROSS/BLUE SHIELD PPO CALIFORNIA

Hey everyone!

I'm still pre-surgery at the moment and am getting down to the wire on sending in the request to my insurance. I wondered what everyone's surgery looked like finance wise for BC/BS California? No one will give me a straight answer. I know it's different for everyone, but a ball park estimate would be nice.

All I have left of my requirements are to have an endoscopy and they say then I'll have my paperwork submitted and my date set.

The major problem with blue cross, however, is that their deductibles reset twice a year, once in January and once in September, and they're crazy high. I'm trying and wishing and praying to have my surgery in December because of that.

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Featured Replies

Hello!

I also have blue cross. My insurance is covering the procedure but I do have a deductible and an OOP expense to meet. Mine is 7,300. The hospital is allowing me to put down a deposit and pay off that amount. If you haven't met your deductible or OOP this year then expect to pay the hospital a pretty penny haha

Hope this helps!

  • Author

Thank you! I've met my perscription deductible, but not my medical deductible I don't think. Unless doctors visits and the consultation count into that. My consultation was billed at $400, but I only paid $40.

Hey everyone! I'm still pre-surgery at the moment and am getting down to the wire on sending in the request to my insurance. I wondered what everyone's surgery looked like finance wise for BC/BS California? No one will give me a straight answer. I know it's different for everyone' date=' but a ball park estimate would be nice. All I have left of my requirements are to have an endoscopy and they say then I'll have my paperwork submitted and my date set. The major problem with blue cross, however, is that their deductibles reset twice a year, once in January and once in September, and they're crazy high. I'm trying and wishing and praying to have my surgery in December because of that.[/quote']

Hi! I have anthem bc of Ca. I have the ***. Do you? The *** covered 100% of it all barring a few $20 copayment office visits. And I had complications so I had to have 2 surgeries. BOTH were 100%

Hi! I have anthem bc of Ca. I have the ***. Do you? The *** covered 100% of it all barring a few 20 copayment office visits. And I had complications so I had to have 2 surgeries. BOTH were 100%

Don't know why it blocked the letter H. M. O.

  • Author

I have a PPO. In the past, my insurance rarely covers anything 100%, which is why I'm a little nervous.

Hi Kay,

I have Anthem BC of CA. My OOP is $2000 and deductible $350 for a total cost of $2,350.00. I paid the surgeon upfront and the hospital I made arrangements with to pay over the next 12 months. I hope this helps.

And I do have PPO

Edited by 1SuperBonBon

As of today, we were just switched to Anthem Blue Cross of CA PPO, so I now have to start all over with the approval process (been working this since the middle of September). What are the requirements for blue cross?

  • Author

My personal requirements were just that it has to be "Medically necessary." Probably because my deductible is so high. $4,000 medical per person. $7000 max out of pocket.

  • 3 weeks later...

I have anthem BC of CA, but mine is thru my spouse's work( LAPD). Its great insurance. I also have a secondary so not sure what I will have to pay. When I had my hysterectomy, I didn't pay anything. I did have to pay 200.00 for the psych and a 600.00 program fee. I am pretty pissed about that.

I have same ins. Sleeved 10/21. My surgeon requires a $2500 "lifestyle management program" fee is hat is not covered by ins. I spent one night in the hospital and I paid about $5000-$5500 all together. My copay is $1000 and out of pocket us $4000. So.. without the program fee about $3000... if I required anoth night in the hospital it would have been another $1500. ***requirements. ..bmi 40+, 100+ lbs overweight or bmi 35+ w/2 co morbidities...

I have same ins. Sleeved 10/21. My surgeon requires a $2500 "lifestyle management program" fee is hat is not covered by ins. I spent one night in the hospital and I paid about $5000-$5500 all together. My copay is $1000 and out of pocket us $4000. So.. without the program fee about $3000... if I required anoth night in the hospital it would have been another $1500. ***requirements. ..bmi 40+, 100+ lbs overweight or bmi 35+ w/2 co morbidities...

  • 3 weeks later...

I have Blueshield of CA (PPO) - not sure if it's the same, but the way our plan is set up is with a high deductible ($1500 for my husband and I) and then after that is met, insurance covers 80% of the cost. It's going to cost me a pretty penny out of pocket, but it will be worth it.

I have anthem bcbs of ca and I was told my out of pocket was $3300 because of a $2500 bariatric deductible. Thank goodness I had a second insurance so im not coming out any money.

  • 2 weeks later...

I have BSBC of MI. I'm scheduled for Sat. I paid. 800. 00 on Thursday at my doctors and they told me the hospital might charge me a separate fee, I don't know why. Today the hospital called ugh to tell me I have a 2000 out of pocket and have only met 500 of it and my insurance pays only 80% of my surgery I have to pay the rest. In the morning they will tell me know how much I have to pay. I'm stressing now over this I hope it's not super high. I met my deductible already.

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