Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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%

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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...

Share this post


Link to post
Share on other sites

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...

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
    • jparadigm

      Happy Wednesday!
       
      I hope everyone is having a lovely week so far! 
      It's been a bit of a struggle this last week...I'm hungry ALL the time.
      · 1 reply
      1. BlondePatriotInCDA

        Have a great Wednesday too! Sorry you're hungry all the time, I'm pretty much the same..and I'm sick of eating the same food all the time.

    • ChunkCat

      Well, tomorrow I go in for an impromptu hiatal hernia repair after ending up in the ER over the weekend because I couldn't get food down and water was moving at a trickle... I've been having these symptoms on and off for a few weeks but Sunday was the worst by far and came with chest pain and trouble breathing. The ER PA thinks it is just esophagitis and that the surgeon and radiologist are wrong. But the bariatric surgeon swears it is a hernia, possibly a sliding one based on my symptoms. So he fit me into his schedule this week to repair it! I hope he's right and this sorts it out. He's going to do a scope afterwards to be sure there is nothing wrong with the esophagus. Here's hoping it all goes well!!
      · 4 replies
      1. AmberFL

        omgsh!! Hope all goes well!! Keeping you in my thoughts!

      2. gracesmommy2

        Hope you’re doing well!

      3. NickelChip

        I hope it goes well! Sending positive thoughts for a speedy recovery!

      4. AmberFL

        How are you doing? any update?!

    • jparadigm

      Hello lovlies!
      Today is a beautiful day in west Michigan! I hope you all have a beautiful Tuesday and rest of your week!! 🤗
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×