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Highmark BCBS out-of-pocket costs

cls5186

By cls5186, in Insurance & Financing

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cls5186    23

cls5186
Posted

Hey guys, i'm about 2 months before surgery and i'm nearly done with all my insurance and surgeon requirements: as per insurance i have had to complete 6 monthly PCP visits, 1 psych visit, structured nutrition plan as overseen by my PCP/surgeon. As per my surgeon i have had to have, 2 chest x-rays, bloodwork, EGD, sleep study (was then diagnosed with sleep apnea), 1 psych visit, EKG. My question and what i've been worried about is payment after all is said and done, i have a balance of $600 after my sleep study i am to pay (after insurance) :( which i'm signing up for an FSA through my employer to pay for these costs, i'm just not sure how much to put on my FSA or credit card they give me, at the first of the new year (2017). Anyone have any idea how much i should estimate for total surgery, one co-pays are made? Just the hospital stay and surgery itself (plus the sleep study cost). I checked out the cost estimator on Highmark's website and it was no help to me at all. Help please!?

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agirlhasnofluff    57

agirlhasnofluff
Posted

The HSA can't be used retroactively, FYI. You must incur the costs in 2017 in order to use 2017 funds. My plan has a carryover of $500, so in theory, I could use $500 of 2016 money in 2017, but not vice versa. The max contribution for someone with just themself on the insurance plan is 2,550. It's what I contributed in 2016, and it was all used up by June, sadly.

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cls5186    23

cls5186
Posted

I'll be honest, i don't know a lot about the HSA/FSA my plan also has a carryover of $500. Any advice you can offer on it would be helpful. I'm applying or getting the account for the next year, as in 2017 which will be the same year as my surgery so nothing will be in 2016.

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cls5186    23

cls5186
Posted

@girlhasnofluff i sent you a pm

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bcl1628    26

bcl1628
Posted

I have Highmark of Delaware and I'm having a similar question. My coinsurance max out of pocket is $500. But there's also a "total max out of pocket" that's like $7k. According to the Highmark glossary, the coinsurance counts towards meeting the total out of pocket costs of $7k. What ridiculous terminology! Did you guys pay anything near $7k?

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      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

      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

        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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      CaseyP1011

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      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      https://alluniqueguide.com/java-burn-coffee-reviews/
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